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Colleen Eddy Elk River Public Arts Committee <br />Printed On: 15 October 2020 FY21 Project Grant Rnd1 13 <br />Applicant Groups <br />Select the one code that best represents 50% or more of the applicant's staff, board or membership. <br />I= Individuals with disabilities; S= Adults older than sixty; V= Military veterans; 99= None of the above; 98= Data <br />not provided <br />99 <br />Street Address* <br />Enter the street address (No P.O. Box), City and Zip Code where the organization is located. <br />13065 Orono Parkway NW <br />Elk River, MN 55330 <br />County* <br />Select the county where the organization is located <br />Sherburne <br />Additional Information - (optional) <br />Data collection questions do not always provide options to accurately describe the racial or ethnic identity of <br />applicants and the groups they serve. If there is additional information you would like to provide about the race or <br />ethnicity of the groups served by the project, include that information here. <br />CERTIFICATION <br />FEDERAL 501(c)(3) NONPROFIT STATUS LETTER <br />All nonprofit organizations must attach their 501(c)(3) letter to this application. Does not apply to public schools. <br />IF YOU ARE USING A FISCAL AGENT, YOU MUST UPLOAD THAT ORGANIZATION'S 501C-3 LETTER. <br />ELECTRONIC SIGNATURE* <br />Enter your full name, business title and today's date. <br />Clicking "I agree" Confirms your signature.* <br />Entering your signature information and clicking "I Agree", certifies that your board of directors/advisory <br />committee supports this application, that it is accurate and that the proposal will be carried out as described if <br />funded. <br />APPLICATION DRAFT REVIEW <br />Applicants may request a draft review of an application. CMAB staff will review the application and identify any <br />concerns, upon request submitted via email (media@centralmnartsboard.org) or fax (320-968-4291), at least three <br />weeks before the application deadline. A review of the application does not guarantee that the request will be <br />funded.