[DC GOVERNMENT] Historic Lincoln Theatre Rental Support Request Form

Lincoln Theatre Rental Support Request Form

View information and eligibility requirements for rental support here.

Date

Contact Name:

Organization:

Email:

Phone Number:

Applicant Type:

Non-profit

Arts Organization

Community Organization: ANC, Civic Association, etc.

Educational Institution

DC/State/Federal Government Agency

Other

If Other, Explain:

Event Title:

Event Type:

Arts Education Program

Non-Arts Education Program

Preferred Event Date:

Event Time:

Projected Attendance:

Event Description:

Event Marketing Plan:

Event Technical Needs from the Venue:

Event Goals – Include objectives, communities served and community engagement effort:

Marketing Expenses:

Programmatic/Artistic Expenses:

Production Labor:

Ticketing Expenses:

TOTAL Event Expenses:

Ticket Sales:

Sponsorships:

Grants:

Funds:

TOTAL Event Revenue:

NET Event Income (Loss):

Itemized Budget Narrative:

Producing Partner(s):

Community 501 (c) 3, ANC, Civic Association

Government: DC Agency or Federal

Educational Institution

Arts Organization

Corporate Entity, Private Industry

Regional, National, International Organization or Governmen

Direct Select/Special Initiatives (Public Art Master Plan)

Other

Partner Name:

Partnership Description:

Work Sample:

Provide an artistic work sample that clearly demonstrates the program’s artistic content. Use the space above to list the work sample and description of the artistic content. (Links may be provided.)

Please attach any files in addition to work samples here:

Click Here to Upload

Additional comments/considerations or special needs:

Certificate of Clean Hands, dated within thirty (30) days prior to the deadline:

Click Here to Upload

Copy of IRS 501(c)(3) Letter of Determination:

Click Here to Upload

Signed IRS Form W-9 (Note: Post office boxes are prohibited):

Click Here to Upload

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