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Artists Emergency fund application

Name

First Name

Last Name

Pronouns

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

Artistic Discipline

How did you learn of the Artists Emergency Fund?

Artist's Statement

A few sentences that describe you, your work and why you make art.

Declaration of Need

Please let us know if you are applying due to lost income, or if you are facing housing, food or healthcare insecurity.

Proof of Practice

Proof of artistic practice is required. Please provide a link to a website with your artistic work or your CV.

http://

How much are you requesting from the Fund? (Up to $1000)

Are you a member of Austin Creative Alliance?

Terms and Conditions

I hereby state that all elements of this application are true.

I understand that this application is subject to approval by Austin Creative Alliance and available funding.

Demographics Information

The following info is used for ACA's grant writing and grant reporting, and is not used in our funding decision process. It is optional, but much appreciated so we have a better idea of who we serve. All information in this application form is protected through data encryption.

What is your ethnicity?

What is your gender?

What is your age?

What is your Austin City Council District Number?