Facilities Access Program Application Applicant Information (0 points, required):Name of applicant organization or group:*Name of Person(s) completing this application:* First Last Emails of person(s) completing this application:* Date of application submission: Date Format: MM slash DD slash YYYY Requested date(s) of Academy facility usage:* Date Format: MM slash DD slash YYYY Requested Academy facilities/spaces:* Select All Historic Academy Theatre Warehouse Theatre Harrington Gallery Building Other Have you applied though this application before:*YesNoEIN number:*Enter EIN Number or N/AProgram category:*Arts/CultureHuman ServicesEducationHave you read the important information:*YesNoSection Program Overview and Logistics (15 points total):The information collected below will be used to determine the applicant’s ability to plan and implement the project.Please describe the event/project you are applying for, its history, and its overall purpose.*What is your plan or what have you already done to successfully organize and execute this project? Please share if you have organized this project in the past or if it is new. Enter the additional information below.*Paid full time staff total:*Paid part time staff total:*Volunteers who average over 20 hours per week total:*Volunteers who average less than 20 hours per week total:*Board members total:*How, if at all, will Academy staff be needed to assist with implementation of the project? Will any production staff or equipment be necessary (lighting, staging, sound, video, tables, chairs, etc.)?*Please also provide a list of your organization’s principal staff, volunteers, and/or board members directly involved in the execution of the project.*Applicant Need (15 points total):The information collected below will be used to determine the applicant’s request for financial assistance.Explain why and how the Academy’s facilities fulfill a need. Please share if your organization has its own facilities/building and also note how the Academy’s spaces would provide the right environment for your event.*Explain why you are financially in need of a discounted rental rate. Strong answers will share why the organization needs financial assistance while also showing an attempt to secure funding.*Total project cash income and expenses*Attach a file itemizibg all sources of funding and expenses for this activitySection Community Value (20 points total):The information collected below will be used to learn about the organization’s mission and determine the potential impact of the project. What is the mission of your organization? Provide details on your history and purpose.*What kind of impact will this project will have on the community. Be sure to share the content and quality of your program.*Please share how your organization would acknowledge, to the greater community, how the Academy made your program possible through a discounted rental.*Share your intended target audiences and why your program is needed by those you wish to serve. This should include information on different demographics served. Fill out the estimated age breakdown below and place an “x” next to any population your project plans on impacting specifically.*Age Breakdown (write estimated count of audience/people served listed below next to each age group)*Youth (under 18), Young adults (18-35), Adults served (35-61), Seniors served (62+), and Total Expected ImpactUnderserved and Under-Represented Demographics (if any, write estimated percentage served listed below next to each group)*Individuals of Limited Income, ALAANA (African, Latinx, Asian, Arab, and Native American) Populations, LGBTQ+ (Lesbian, Gay, Bi-sexual, Transgender, Queer, etc.) Populations, Individuals with Mental and Physical challenges, Military Members and Veterans, Homeless Populations, and OtherCommentsThis field is for validation purposes and should be left unchanged.