Arrowhead Regional Arts Council Marshall Professional Building, 1301 Rice Lake Road, Suite 120 Duluth, MN 55811 • 218-722-0952 • 800-569-8134 [email protected] • www.aracouncil.org RURAL ARTS and CULTURE SUMMIT SCHOLARSHIP APPLICATION Scholarships are available to individuals from the Arrowhead region to participate in the 2015 Rural Arts and Culture Summit, which will held in Morris, MN on June 2 - 4, 2015. Scholarships will be awarded on a first come, first served basis. Carpooling is encouraged to allow as many people as possible to participate. Funding is made possible by the voters of Minnesota thanks to a legislative appropriation from the arts and cultural heritage fund. This year’s theme is “FROM THE GROUND UP: CULTIVATING CREATIVE PEOPLE AND PLACES.” The Summit will gather artists, art organizations, rural-centric organizations, and community and economic development leaders to learn about creative people and places that have built their stories “from the ground up.” People from across the state and country will gather to celebrate the imaginative and creative thinking that has helped to create vibrant small town cultures. For more information about the Summit and to register please go to their website: www.ruralartsandculturesummit.com The 2015 Rural Arts and Culture Summit Hosted by a partnership between Springboard for the Arts, the Center for Small Towns, and the Forum of Regional Arts Councils. Register, complete, and return this form to ARAC as soon as possible, but no later than May 31, 2015. Either print and mail or save and email an attachment to ARAC. Limited funds are available for this first come, first served opportunity. You must retain receipts for your registration and lodging to turn in with your final report/reimbursement request. Applicant Name: Organization Name (if applicable): What is your role with this organization? If individual artist, what is your primary arts discipline? Address: City State Zip: Telephone (Best Daytime): E-Mail: What do you hope to gain from this experience and how will you apply that to your work? (SCHOLARSHIP APPLICATION CONTINUED ON NEXT PAGE) Please provide your projected expenses for participating in the Summit. A copy of this form will be returned to you upon approval, to be completed with actual expenses and returned with receipts for reimbursement. Maximum award: $110 for registration and Wed. supper, $40/night housing, plus round trip mileage at $.40/mile. Name: Projected Expense Actual Expense Registration Fee at early bird rate: $100/2 days, $70/1 day (if registering after April 22nd, additional cost is your responsibility) Travel (stipend based upon $.40/mile) Projected miles round trip: ________ Round trip miles _____ X $.40 = Round trip miles _____ X $.40 = Actual miles round trip: _________ Lodging stipend: maximum $40/per night Wednesday evening dinner and entertainment: $10.00 (Wed & Thurs breakfast and lunch provided with registration fee) TOTAL (You may receive reimbursement of up to $400. Any additional expenses are the responsibility of the applicant.) I certify the information in this application is true and correct to the best of my knowledge. If awarded a scholarship, I understand that I must submit a final report of expenses, and include conference registration and lodging receipts and number of actual miles driven no later than June 17, 2015 in order to be reimbursed for these expenses. Name: ____________________________________ Signature: _________________________________ Date: _________________________________ If awarded, reimbursement check should be made out to: _______________________________________ COMPLETE AND MAIL OR EMAIL TO ARAC (see header above for address)