3201 Allen Parkway, Houston, TX 77019Phone: (713) 527-9330 Fax: (713) 630-5210

Website: www.haatx.com

FY10 ARTS PROJECT GRANT REVISION FORMGeneral Instructions: Download this form from www.haatx.com under Programs and Grants/Managing Your Grants and save the document to your computer. Complete the form and then email as an attachment to the attention of Liz Alexander at Liz@haatx.com.

For assistance: Please contact the Grants Department at 713-527-9330.

As your original request amount may not be the same as the Grant Award, please indicate on the attached sheets how your budget will change and whether the project will be changed significantly.

REMINDER: Arts Project Grants must be matched dollar for dollar from cash sources other than the Houston Arts Alliance or other City of Houston Hotel Occupancy Tax Funds. Matching funds must be collected (not just pledged or awarded) during the term of the grant.

The 1:1 match also applies to the Project’s cash expenses. The Houston Arts Alliance grant funds may be used to pay for up to 50% of the Project’s cash expenses; matching funds must be used to pay for 50% of the Project’s cash expenses. In the event that the 1:1 ratio is not achieved, the grant award may be adjusted accordingly.

Grant Revision Form. Grantees awarded Arts Project Grants are required to submit a Grant Revision Form to the Houston Arts Alliance at all subsequent times when any of the following conditions apply:

1. The grant amount received is less than the request in the Grant Application.

2. The Grantee plans to change how the grant will be spent from what was indicated in the Grant Application.

3. The Grantee plans to change the purpose, intent, goal, dates, scheduling, timing or geographic location of activities compared to what was outlined in the Grant Application.

4. The Grantee plans a change of twenty-five percent (25%) or more in the audience to be served, including, but without limitation, targeted ethnicities or age groups.

5. The Grantee plans a change in artistic personnel, such as key artists responsible for planning, directing or participating in the project activity.

6. The Grantee plans any omission or alteration of public aspects of project activities, including without limitation, performances, exhibitions, classes, calls for entries or auditions, venues, or locations of where activities will be held.

FY 2009 Grant Revision Form Page 1 of 5

Houston Arts AllianceFY10 ARTS PROJECT GRANT REVISION FORM

Grant Number: FY10 -       - APGThis number can be found on your award letter or Grant Agreement.

A GRANTEE ORGANIZATION INFORMATION

Organization Name:       Org Phone:      

Address:       Fax Number:      

City, State ZIP       St:       Zip      

Contact Person:       Day Phone:      

Title:       Alt Phone:      

Website:       Email:      

Original Amount Requested $       Project Grant Starts      

Actual Amount Awarded $       Project Grant Ends      

D REVISED PROJECT DESCRIPTION

Provide a brief description of the project as proposed in the original application.     

Based on the grant award amount, please describe any changes from the original application including the number of activities, performances or exhibitions planned, or other major changes in artistic programming. If there are no changes, please indicate no changes.     

FY 2009 Grant Revision Form Page 2 of 5

BREVISED CASH FINANCIAL INFORMATION. Use this section to provide the projected CASH budget for the project; include only the revenue that will be received or earned for the project during the period of support. The proposed budget must include all revenues related to the project described in the original application (including expenses that will not be funded by Houston Arts Alliance). Do not include in-kind information.

Earned RevenueCash Revenue

ONLY

1. Admission charges, subscriptions, box office receipts      

2. Concessions, sales, parking, publications, rentals, advertisers, etc.      

3. Tuition, class and workshop fees      

4. Interest on Investments, endowments      

5. Other Earned Income      

6. Subtotal Earned Revenue (sum of lines 1-5)      

Unearned or Contributed Revenue

7. Fundraising/Benefits and Galas      

8. Individual Contributions      

9. Memberships      

10. Corporations (contributions from businesses, corporations or corporate foundations)

     

11. Foundations (contributions from private foundations)      

12. Federal Government (list agencies below)

           

           

           

13. State Government (list agencies below)

           

           

14. Local Government (list agencies below)

           

           

           

15. Houston Arts Alliance Grant (This grant only)      

16. Sub-total Unearned or Contributed Revenue (sum of lines 7-16)      

17. Total ALL Revenue (sum of line 6 + line 16)      

The total revenue must match the total proposed expenses on page 3

FY 2009 Grant Revision Form Page 3 of 5

C

REVISED CASH FINANCIAL INFORMATION. Use this section to provide the project CASH budget for the project; include only the expenses that will be received or earned for the project during the period of support. The proposed budget must include all expenses related to the project as described in this revised application (including expenses that will not be funded by Houston Arts Alliance). Do not include in-kind information.

Please note that expenses and revenue must balance.

Revised CASH ExpensesTo be Paid with CACHH Grant

To be Paid with Other Revenue

1. Personnel

a. Administrative            

b. Artistic            

c. Technical            

d. Fringe Benefits            

2. Outside Professional Fees/Contracts

a. Administrative            

b. Artistic            

c. Technical            

3. Travel            

4. Miscellaneous Operating Expenses

a. Space Rental            

b. Equipment rental            

c. Supplies and materials            

d. Marketing/Promotion            

e. Printing            

f. Postage            

g. Insurance            

5. Production and Exhibit Costs

a. Shipping & transportation            

b. Exhibit Rental Fees            

c. Other Production Costs            

6. Other Expenses (detail below)

                 

                 

                 

7. Total Proposed Expenses $            

The total proposed expenses must match the total proposed revenue on page 2

Total amount of both columns:      

FY 2009 Grant Revision Form Page 4 of 5

EREVISED DEMOGRAPHIC INFORMATION. Complete the following ONLY if the projected audience and artists involved have changed. Please enter the number for each demographic characteristic below.

1. Total Audience for project (APG): Enter the revised projected number of people who will attend during the July 1, 2008 - June 30, 2009 period.

     

(a). Race/Ethnicity Audience NumbersAfrican American      Asian American/Pacific Islander      Caucasian      Latino/Hispanic      Native American      Multi-Racial      TOTAL       This number should be the same as item E-1 above.

(b). Age Groups Audience NumbersYouth Under 18      Adults (18-64)      Seniors (65 and over)      TOTAL       This number should be the same as item E-1 above.

(c). Other Audience Numbers

Tourists and visitors (all ages)       These two items do NOT need to equal item E-1 above.People with disabilities      

FREVISED DEMOGRAPHIC INFORMATION of Artists, Performers or Cultural Experts. Please enter the number for each demographic characteristic below.

1. Total number of Artists, Performers and Cultural Experts:      

(a) Race/Ethnicity Artists/Cultural Experts:African American      Asian American/Pacific Islander      Caucasian      Latino/Hispanic      Native American      Multi-Racial      TOTAL       This number should be the same as item F-1 above.

(b) Age Groups Artists/Cultural Experts:Youth Under 18      Adults (18-64)      Seniors (65 and over)      TOTAL       This number should be the same as item F-1 above.

(c) Other People with disabilities       This item does NOT need to equal item F-1 above

FY 2009 Grant Revision Form Page 5 of 5