Art Grant Agreement Form
In order to receive payment, the person completing this grant agreement form must be a U.S. resident. This is the contact person for fiscal purposes, not necessarily the lead artist.
First Name *
Your answer
Last Name *
Your answer
Lead Artist Name (if different)
Your answer
Email Address *
Your answer
Phone *
Your answer
Name of Project or Installation *
Your answer
Dollar Amount of Art Grant *
Your answer
Please check the following: *
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AGREEMENT: By accepting the terms and conditions, the Grant Recipient understands and agrees that granted funds are to be used only for the purposes set forth in their application, which is incorporated by reference herein. If, for whatever reason, the art project does not appear at the specified event, the Grant Recipient is responsible for returning the entire amount of the Art Grant funds to Burnt Oranges no later than 30 days following the conclusion of the event. The only exception to this is uncontrollable ‘Acts of God,’ which are defined at the discretion of Burnt Oranges. Grant Recipient agrees that Burnt Oranges may take photographs of the art project for use in promotional materials and consents to such use. Grants of $600 or more will not be issued unless Grant Recipient submits a form W9 in addition to this agreement.* *
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