SECTION 1 | PERSONAL INFO

Section 1 asks you to provide basic info about yourself and how we can contact you.

Preferred Name, if different from above

Preferred Pronouns *

Please check the set(s) of pronouns you prefer us to use in our communications with you or regarding you as an applicant.

She/Her

They/Them

He/His

Zhe/Zhem

Email Address *

Best Way To Reach You *

Please let us know the best way to contact you about grant-related questions.

If you have selected other, please fill in the box below

Section 2 | Demographic Info

Please provide us with information about your economic and racial background.

How many people are in your household? *

Please include yourself, those who are financially dependent on you and/or those whom you might be dependent upon. Please do not include co-op housemates, apartment mates, et al.

Which best describes your total annual household income? *

If you are in-between employment or cannot easily determine your annual household income, please explain more here:

How do you identify racially? *

Check one or all that apply.

Black or African

Asian

Latino

Indigenous or Native

Multiracial

Other

If you have selected other, please fill in the box below

How do you identify ethnically?

Section 3 - Artist and Project Info

The CreateWell Fund aims to support artists' creation of original artwork that honors one’s authentic artistry.

This refers to artwork whose primary intent is non-commercial--a work of personal vision and value that an artist is otherwise unable to pursue, due to financial or well-being concerns or barriers. (Examples of proposals that will not be considered: the post-production phase of a project, arts festivals, educational programs, or operating costs for nonprofit art programming.)

Artist Name *

If you have an alias that you use to represent your artwork or performances, please provide this name here. Likewise, if you use your real name, please provide how you prefer to see it in print.

Artist Statement *

Please provide a description of your artistic vision, purpose and process.

Project Description *

Please describe the artistic work you seek funding for. Please describe the concept and intent of the work. Include as much detail about the pre-planning or planning process as you can.

Please select the medium(s) you plan to work with for the proposed project. *

Please choose one or more that apply. Please select "other" if your medium is not included in this list.

Comedy

Dance

Fashion Design

Film

Graphic Design

Illustration

Installation

Music

Performance Art

Photography

Print

Public or Street Art

Puppetry

Screenprint

Theatre

Video or Digital

Writing

Other

If you have selected other, please fill in the medium(s) below you will be working with.

What is your goal for publishing/exhibiting/performing the proposed art work once completed? *

Section 4 | Wellness Goal

The CreateWell Fund believes the care of an artist's mental, emotional and physical health is as valuable as the pursuit of their artistic passion.

Our ideal candidates will demonstrate an earnest need and commitment to using grant funds to achieve both the artistic and wellness goals they propose. CONFIDENTIALITY STATEMENT: Any personal information about your health that you choose to provide below will be kept confidential and will not be used against you in the application review process. We use this information only to get a more holistic picture of who you are.

What is the wellness goal you would like to support with funding? *

Please share one or more wellness goals you would like to receive funding support for. An appropriate wellness goal will be realistic and achievable within the grant term. Examples of appropriate wellness goals include: purchasing and eating more homemade wheat-free food due to a severe wheat allergy or going to physical therapy due to a recent or chronic injury. While we support all wellness practices, please do not include those wellness goals that do not require funding from the grant in your response.

Your Wellness Plan *

In your wellness plan, please explain 1) the incremental steps or processes you will take to work on your wellness goal within your grant term, and 2) your plan for documenting your progress.

What is your outlook on wellness? How do you practice care for your well-being now? *

Modes of Healing and Care *

Please check one or more of the modes of healing and care you propose to use funding for.

"Alternative" Treatments (Acupuncture, Ayurveda, Herbs, Homeopathy, etc)

Coping with Addiction

Exercise

Injury or Trauma Recovery

Maternity Care

Mental Health Services

Medical or Pharmaceutical costs

Nutrition

Sleep Quality

Other

If you have selected other, please fill in additional areas of wellness below with commas separating them.

Would you be interested in documenting your progress to share publicly? *

Section 5 | All About the Money

Budget Proposal

Select the amount range you plan to spend in each category of expenses below.

Project Materials *

Stipends for self, assistant(s), and/or collaborator(s). *

Wellness Services or Supports *

Please fill in the total funding request ($1200 min, $6000 max).

$

Grant Term

Please choose the length of your artistic project, during which you will use the funds you receive. Choose the term closest to the actual time you anticipate needing, i.e. select "6 months" for a five-month project.

PORTFOLIO SUBMISSION *

Digital portfolio can be emailed to thecreatewell@gmail.com with "APPLICANT NAME_PORTFOLIO" in the Subject line. Non-digital portfolios can be mailed to: CreateWell Fund, P.O. Box, E Longmeadow, MA 01028. Postmarked by deadline.

I understand that I need to submit at least three portfolio pieces, following the above instructions, for my application to be considered complete.

How did you learn about this grant opportunity?

If you have selected other, please fill in the box below

Additional Comments (Optional)

If you have additional comments to you would like to add, please fill them in below.