3135-0112 Challenge America Grant Application Form

Blanket Justification for NEA Funding Application Guidelines and Reporting Requirements

Challenge America Grant Application Form

Blanket Justification for NEA Funding Application Guidelines and Reporting Requirements for Nonprofit Organizations

OMB: 3135-0112

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 3135-0112 can be found here:

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Challenge America GAF, FY 2018

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[ Table of Contents ]
o View Application Data
o Part 1a: Organizational Information
o Part 1b: Programmatic Activities
o Part 2: Project Information
o Part 3: Project Budget
o Part 4: Items to Upload
o Part 5: Organization and Project Profile

View Application Data

The data below is from the application you submitted through Grants.gov. It is for review only; this information
cannot be edited here. If changes are needed, contact the NEA.

Category
Applicant Organization Name

Organization Address

Organization Address 2
Applicant Organization City
Applicant Organization State
Organization Zipcode

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Organization Website

1000 characters remain

Project Start Date
Project End Date
Project Director Prefix Name
Project Director First Name
Project Director Middle Name
Project Director Last Name
Project Director Title

Challenge America GAF, FY 2018

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[ Table of Contents ]
o View Application Data
o
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Part 1a: Organizational Information

Part 1b: Programmatic Activities
Part 2: Project Information
Part 3: Project Budget
Part 4: Items to Upload
Part 5: Organization and Project Profile

Part 1a: Organizational Information
Please refer to the NEA's website for instructions on how to fill out the Grant Application Form, as well as what items to
upload, in "Step 2: Submit Materials to NEA-GO". See here for more information: https://www.arts.gov/grants-

organizations/challenge-america/step-2-submit-through-nea-go
OMB Number: 3135-0112
Expiration Date: TBD
NOTE: All red asterisked (*) items on this form are required and must be completed before you will be able to submit the
form.
Legal Name (per your IRS Determination Letter): *
Popular Name (if different):

Nobody Knows

Nobody

For this application, are you serving as the Parent of an Independent Component: *
Mission of your organization:

Briefly summarize the mission of your organization. For non-arts organizations (e.g., universities, human service agencies),
summarize your mission as it pertains to your cultural programs or services. *

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102 characters to remove

Please enter required value or fix the error.
Briefly summarize the background/history of your organization. *

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2000 characters

Organization Budget: Complete this section using figures from completed fiscal years. If you are a parent organization, this
information should refer to the component on whose behalf you are applying.

FY End Date (MM/DD/YYY

Income

Earned

Contributed

TOTAL INCOME

Expenses

Artistic Salaries

Most Recently Complete

Previous FY

Two FYs Prior

12/31/2015

12/31/2014

12/31/2013

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Production / Exhibition

Administrative Expenses

TOTAL EXPENSES

Operating Surplus / Def

ADD ROW FOR CUMULATIVE SURPLUS/DEFICIT
In the space below, discuss the fiscal health of your organization. In addition, you must explain: 1) any changes of 15% or
more in either your income or expenses from one year to the next, and 2) plans for reducing any deficit (include the factors
that contributed to the deficit and its amount). *

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[ Table of Contents ]
View Application Data
Part 1a: Organizational Information
Part 1b: Programmatic Activities
Part 2: Project Information
Part 3: Project Budget
Part 4: Items to Upload
Part 5: Organization and Project Profile

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Part 1b: Programmatic Activities
Programmatic Activities
Submit representative examples of your programmatic activities for the past three years/seasons (up to 5 examples per
year/season). While the headings may not fit in every case, use these spaces to demonstrate what your organization has done
for the last three years. Note: You can't change the years/seasons. If you need to provide information for different
years/seasons, please note the years you are using in the "Programmatic Activity notes" section below.
These examples should demonstrate eligibility (i.e., your organization's three-year history of programming) and the artistic
excellence and merit of your organization. For projects that involve touring, list your organization’s touring activities for the
past three years/seasons. If you do not have touring information, leave the section blank (i.e., do not type "N/A").

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Year 1
REQUIRED FIELD
Representative examples: REQUIRED FIELD

(3,500 Character Limit, including spaces)

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Year 2
REQUIRED FIELD

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Representative examples: REQUIRED FIELD

(3,500 Character Limit, including spaces)

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Year 3

•

Representative examples: REQUIRED FIELD

REQUIRED FIELD

(3,500 Character Limit, including spaces)

Programmatic Activity notes:
Provide any notes about your programmatic activity.

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Part 2: Project Information
NEA Discipline for Proposed Project: This refers to the artistic discipline associated with your project, not necessarily your
organization as a whole.
MODIFY THEATER & MUSICAL THEATER TO THEATER; ADD MUSICAL THEATER; UPDATE CODES; NOTIFY
ITM FOR DATA MANAGEMENT

Challenge America: Arts event(s) with guest artist

NEA Grant Category: *
Who is your Guest Artist? *

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33 characters to remove

Please enter required value or fix the error.
What is the Guest Artist's role in the culminating event? *

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Project Activities
Project Title: If your project title has changed since you submitted your SF-424 through Grants.gov, provide a new project
title in the text field below. Text cannot be formatted (e.g., bold, italics). If

you have no changes, leave the text
as is. Do not type "N/A" as this will replace the previously submitted project title.

Project Description: If your project description has changed since you submitted your SF-424 through Grants.gov, provide a
new description in the text field below. Text cannot be formatted (e.g., bold, italics). If

you have no changes, leave
the text as is. Do not type "N/A" as this will replace the previously submitted project
description.

980 characters remain

Major Project Activities: This serves as the project narrative. Describe the proposed project. Be as thorough
and specific as possible about the Challenge America project type you identified above and the activities that will take place
during the allowable project period. Where relevant, include

information on any additional public
components such as educational or outreach activities associated with the project. Do not
describe unrelated organizational programming. If applicable, identify any works of art that will be central to the project and
the reason for their selection.
Please see the "Grant Program Description" for Challenge America (https://www.arts.gov/grants-organizations/challengeamerica/grant-program-description) to make sure that your project fits within your selected project types: Guest artists,
unified promotion, or public art projects. *
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Testing 12345679 192393485

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Selection of Key Individuals: Briefly describe the process and criteria for the selection of key individuals who will be
involved in this project (e.g. primary artist(s), project director, artistic director, executive director, teaching artist, curator,
editor, folklorist, conductor). Where relevant, name the key individuals and describe their involvement in the
development of the project to date. Where they remain to be selected, describe the procedures that you plan to follow and the
qualifications that you seek. *
1234567890010101010101010101010

1010101010101010101Testing 12345
Testing 12345679 192393485

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192 characters to remove

Please enter required value or fix the error.
Bios of Key Individuals: Include brief, current biographies of the key individuals. You may include up to 5.
First Name
Last Name (use this field for artistic group names or single names)
Proposed or committed?
Bio including

Committed

the proposed role in the project

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990 characters remain

First Name
Last Name (use this field for artistic group names or single names)
Proposed or committed?
Bio including

Proposed

the proposed role in the project

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Add more Individuals?

Yes

First Name
Last Name (use this field for artistic group names or single names)
Proposed or committed?
Bio including

Proposed

the proposed role in the project

◢

989 characters remain

First Name
Last Name (use this field for artistic group names or single names)
Proposed or committed?
Bio including

Select

the proposed role in the project

◢

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First Name
Last Name (use this field for artistic group names or single names)
Proposed or committed?
Bio including

Select

the proposed role in the project

◢

1000 characters remain

Selection of Key Organizational Partners: If your project involves organizational partners, describe the process and criteria
for the selection of key organizations. Where relevant, describe their involvement in the development of the project to date.
Where they remain to be selected, describe the selection procedures that you plan to follow and the qualifications that you
seek. An organizational partner is an outside entity that will provide resources (other than money) to support the project.
Because all NEA projects require matching resources from non-federal sources, organizations that only provide money are
not considered partners. Funders are not excluded from being partners, but they must also supply human resources or
information capital, or actively participate in another way.

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1000 characters remain

Description of Key Organizational Partners: Include brief, current descriptions of the key organizational partners and

their proposed role in the project. You may include up to 10.
Organization Name
Select

Proposed or committed?
Description of the Organization

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Organization Name
Select

Proposed or committed?
Description of the Organization

◢

500 characters remain

Organization Name
Select

Proposed or committed?
Description of the Organization

◢

500 characters remain

Organization Name
Select

Proposed or committed?
Description of the Organization

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◢

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Organization Name
Select

Proposed or committed?
Description of the Organization

◢

500 characters remain

Add more Organizations?

Select

Organization Name
Select

Proposed or committed?
Description of the Organization

◢

500 characters remain

Organization Name
Select

Proposed or committed?
Description of the Organization

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◢

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Organization Name
Select

Proposed or committed?
Description of the Organization

◢

500 characters remain

Organization Name
Select

Proposed or committed?
Description of the Organization

◢

500 characters remain

Organization Name
Select

Proposed or committed?
Description of the Organization

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Underserved Populations
Identify the specific underserved audience(s) your project is intended to reach. For the Challenge America category, all
projects must extend the reach of the arts to one of the four populations. See here for more information
https://www.arts.gov/grants-organizations/challenge-america/grant-program-description .

(To select more than one option on Windows, hold down the CTRL key and select multiple options.
To select more than one option on Mac, hold down the Command key and select multiple options.)

Select
Geography
Ethnicity
Economics

Intended Audience/Participants/Community
Who will benefit from the project and how? In your response, address the expected benefit. For the Challenge America
category, in your narrative, please describe specifically how your project will extend the reach of the arts to underserved
populations as defined by either geography, ethnicity, economics, or disability. *

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Schedule of key project dates: Describe the significant dates in the project. If you include activities that occur before
January 1, 2017, indicate by adding an asterisk (*) and make sure that those activities and costs are not included on the
Project Budget form. *

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Promotion & Publicity: Briefly describe your plans for promoting and/or publicizing the project. *

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999 characters remain

Performance Measurement: How will you measure the success of your project? Describe any plans you have for program
evaluation, for working collaboratively with researchers, strategic consultants, program evaluators, and/or any other plans for
performance measurement related to the project.
Please see "Program Evaluation Resources" (https://arts.gov/grants-organizations/art-works/program-evaluation-resources)
for additional information. *

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Part 3: Project Budget
REDUCE SALARIES/WAGES TO 7 LINES
REDUCE TRAVEL TO 5 LINES
REDUCE OTHER TO 14 LINES

Budget descriptor fields with more than 100 characters will be truncated when reviewed by reviewers.

Expenses
1. Direct Costs: Salar

TITLE AND/OR TYPE O

NUMBER OF PERSON

ANNUAL OR AVERAG

% OF TIME DEVOTED

AMOUNT

100000

100

$100,000

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Total Salaries and wa

$ 100,000

Fringe Benefits

Total fringe benefits

Total salaries and fri

$ 100,000

2. Direct Costs: Trave

# OF TRAVELERS

FROM

AMOUNT

$500

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Total Travel

$ 500

3. Direct Costs: Othe

AMOUNT

artists

$100,000

other

$25,000

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Total other expenses

$ 125,000

4. Total Direct Costs

$ 225,500

5. Indirect Costs (if a

Federal Agency:

Rate (.0000):

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Base:

Total Indirect Costs

6. Total Project Costs

$ 225,500

Income
1. Amount Requested fr

$10,000

2. Total Cost Share/Matc

Cash

Cash Amount

Refers to the cash donations, grants, and revenues that are expected or received for this
project.
$0
$0
$0
$0
Total cash (a):
In-kind

In-kind Amount

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$0
$0
$0

$0
0

Total In-Kind (b):
Total cost/share match f
3. Total project income (

The amounts below will populate from what you have entered after clicking Save at the bottom.
Total Project Income MUST equal Total Project Costs.
If they do not equal, you must adjust your figures in your budget above and Save. If you included an Indirect Cost Rate,
the figures may not exactly match. In this case, click Save and continue.
Amount Requested from the NEA (1)
Total Cost Share/Match (2a 2b)
TOTAL PROJECT INCOME (3)
TOTAL PROJECT COSTS (4 5)

$10,000

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Part 4: Items to Upload
Upload your work samples here.
Reviewers will not review more than 20 minutes of work samples.

Upload files here. DO NOT click the Manage Folders button. Simply click Upload and reorder or edit your files if necessary:

Folder is Empty.
Folder Name: CA FY17-CA FY17
Folder Size: 0.00 MB
User Storage: 120.723MB out of 250MB Used, 129MB Available
Upload requirements Min # Max # Max File Size Uploaded
Images

20 MB

Videos

250 MB

Documents

40 MB

Audios

20 MB

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Part 5: Organization and Project Profile
The National Endowment for the Arts collects basic descriptive information about all applicants and their projects. The
information that follows will help the NEA to comply with government reporting requirements, and will be used to develop
statistical information about the organizations and projects it funds to report to Congress and the public. Your responses will
not be a factor in the review of your application.
Applicant Organization Discipline: Select the primary discipline that is most relevant to your organization and, optionally,
up to two additional disciplines. This refers to the primary artistic emphasis of your organization. This selection will not be
used in the review of your application. See Part 2: Project Information: NEA Discipline to choose the discipline that you
would like to review your project. *
DISCUSS WITH ORA CHANGING THEATER & MUSICAL THEATER TO MUSICAL THEATER AND THEATER;
CODING IMPLICATIONS; IF CODING IMPLICATIONS NOTIFY ITM FOR DATA MANAGEMENT
Applicant Organization Discipline: Optionally, choose up to two additional disciplines.
(To select more than one option on Windows, hold down the CTRL key and select multiple options.
To select more than one option on Mac, hold down the Command key and select multiple options.)
DISCUSS WITH ORA CHANGING THEATER & MUSICAL THEATER TO MUSICAL THEATER AND THEATER;
CODING IMPLICATIONS; IF CODING IMPLICATIONS NOTIFY ITM FOR DATA MANAGEMENT
Applicant Organization Description: Select the primary description that is most relevant to your organization and,
Arts Center

optionally, up to two additional descriptions. *
Applicant Organization Description: Optionally, choose up to two additional descriptions.
(To select more than one option on Windows, hold down the CTRL key and select multiple options.
To select more than one option on Mac, hold down the Command key and select multiple options.)
Select
Artists' Community, Arts Institute, or Camp
Arts Center
Arts Council / Agency

Project Activity Type: *
Additional Project Activity Type Optionally, choose up to two additional activity types.
Apprenticeship

(To select more than one option on Windows, hold down the CTRL key and select multiple options.
To select more than one option on Mac, hold down the Command key and select multiple options.)
Select
Apprenticeship
Arts Instruction - Includes lessons, classes and other means to teach knowledge of and/or skills in the arts
Artwork Creation - Includes media arts, design projects, and commissions

Audience/Participants/Communities
If known, select all descriptors that best describe the intended audience/participants/communities that the project aims to
reach.
Race/Ethnicity (choose all that apply)
(To select more than one option on Windows, hold down the CTRL key and select multiple options.
To select more than one option on Mac, hold down the Command key and select multiple options.)
o Race/Ethnicity - U.S. federal government agencies must adhere to standards issued by the

Office of

Management and Budget (OMB) in October 1997, which specify that race and Hispanic origin (also known as
ethnicity) are two separate and distinct concepts. These standards generally reflect a social definition of race and
ethnicity recognized in this country, and they do not conform to any biological, anthropological, or genetic criteria.
Origin can be viewed as the heritage, nationality group, lineage, or country of birth of the person or the person’s
ancestors before their arrival in the United States.
 American Indian or Alaskan Native - A person having origins in any of the original peoples of North and South
America (including Central America) and who maintains tribal affiliation or community attachment.
 Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian
subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine
Islands, Thailand, and Vietnam.
 Black or African American - A person having origins in any of the Black racial groups of Africa.

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Challenge America GAF, FY 2018

Hispanic or Latino - People who identify their origin as Hispanic, Latino, or Spanish may be of any race.
Native Hawaiian or Other Pacific Islander - A person having origins in any of the original peoples of Hawaii, Guam,
Samoa, or other Pacific Islands.
White - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Select
American Indian or Alaskan Native
Asian
Black or African American

Age Ranges (choose all that apply)
(To select more than one option on Windows, hold down the CTRL key and select multiple options.
To select more than one option on Mac, hold down the Command key and select multiple options.)
Select
Children/Youth (0-18 years)
Young Adults (19-24 years)
Adults (25-64 years)

Underserved/Distinct Groups (choose all that apply)
(To select more than one option on Windows, hold down the CTRL key and select multiple options.
To select more than one option on Mac, hold down the Command key and select multiple options.)
Select
Individuals with Disabilities
Individuals in Institutions (include people living in hospitals, hospices, nursing homes, assisted care facilities, correcti
Individuals below the Poverty Line

Be sure to click Save before clicking Submit.
You must click Submit to finalize your application for NEA review.
Don't forget to hit the "Submit" button when you are ready to submit your application. If you do not hit the "Submit" button,
your application will not be received.

After submitting your application, you may log back into NEA-GO and make modifications to your
submission up until the system closes on the day of the deadline. Remember to hit the "Save" and
"Submit" button again prior the deadline.
You will receive confirmation of your successful submission in two ways: 1) a pop up on your screen, and 2) an email from
[email protected]. Maintain documentation of your successful submission (take a screenshot and/or keep the email).
If you modify your application after you submit, you will not receive additional confirmations.

You also can confirm that your application was received when you log in to NEA-GO. On the first screen it will say
“Received” if your application has been received. If your application has not yet been received, it will say “In Progress.”

File Type	application/pdf
Author	Jillian Miller
File Modified	2016-08-30
File Created	2016-08-30