Arts Council of Winston-Salem/Forsyth County & Art Nouveau Artist Relief Impact Fund Application
We encourage any artist or arts presenter in need of support due to cancellations or postponements because of the COVI-19 crisis to fill out this application. Bands and performance groups are included. This Fund will prioritize NEED. All demographic information obtained will be used to address need on an equitable basis that considers diversity. We encourage every artist regardless of background to apply!

A few important notes:

1. Applications will be reviewed by a panel of Arts Council staff and Art Nouveau members.

2. Incomplete applications will not be reviewed. We will notify anyone who submits an incomplete application via email.

3. The Fund will prioritize NEED. Priority will be given to artists in Forsyth County and areas of Winston-Salem. We will do our best to help as many artists as we can, but grants will be based on the availability of funds.

4. We may be unable to provide the full amount of larger requests.

An artist or arts presenter includes the following:
• Dancer, actor, choreographer, photographer, videographer, teaching artist, musician, visual & craft artists, filmmaker;
• Related personnel such as: technicians (lighting, stage management, production, etc.), independent presenters, producers, agents and/or managers.

An Artist is not eligible to apply if he/she/they:
• Did not lose freelance or contract work as a direct result of the COVID-19 crisis;
• Is based outside of the Forsyth County, Winston-Salem area; and/or
• Is not an individual or group of individuals (i.e. no organized legal entity is eligible).

Please make sure you are able to provide proof of the claimed losses in the form of a letter, email or contract from the relevant contractor/employer that indicates:
• The original date of the cancelled or postponed activity,
• The reason for cancellation/postponement,
• The monetary value of the opportunity,
• A description of the nature of the work,
• The following information about the organizer of the cancelled/postponed activity:
        o Legal name
        o Principal contact name
        o Title of the principal contact
        o Contact information of principal contact

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Email *
Full Name *
Phone *
Mailing Address
City *
County
State *
Zip Code *
Please list website/social media handles
Has one of your creative opportunities/gigs been canceled due to the health crisis of COVID-19, also known as coronavirus? (NOTE: If you had to cancel because you are a person with disabilities, or if you are immuno-compromised, please also mark 'yes' and specify in your description) *
Please describe the opportunity/gig(s) that was canceled. Be sure to include the DATE(s) and LOCATION(s) as well as the AMOUNT(s) you were to be compensated for this work. *
Please provide the Principal Contact's name and information of the contractor/employer/organization who booked you and/or would have been responsible for paying you for the event(s) that were canceled. *
What is the minimum amount of money you need to cover your immediate expenses? *
Have you received other funds from similar relief campaigns? If so, how much in total have you received? *
Are there any additional ways that we could support you at this moment?
Cultural Background (select all that apply):
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Other identifiers (check all that apply):
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