A Night For Austin Application

Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What county do you live in?*

How many people are in your household, including yourself?*

What is your monthly income?

Date of birth*

What is your gender?

Female
Male

The purpose of this question is to report the population we serve in an aggregate basis, it does not affect your chances of receiving this grant.

What is your ethnicity?

The purpose of this question is to report the population we serve in an aggregate basis, it does not affect your chances of receiving this grant.

Are you a veteran?

Yes
No

The purpose of this question is to report the population we serve in an aggregate basis, it does not affect your chances of receiving this grant.

Please explain what you plan to use this funding for.*

Please upload a valid form of ID.*

Max. file size: 50 MB.

Driver’s license, Visa, Green card, or passport are accepted.

Please upload a most recent bank statement or paystub from an outside source of income*

Max. file size: 50 MB.

Please provide proof of being a musician in the Austin area OR a formal statement

Please upload proof of being a music artist in Austin area.

Max. file size: 50 MB.

Contracts, paystub from music venue, or schedule of tax return is accepted.

Formal Statement

This statement should include a description of the artist’s role within the industry. Example: I, NAME, attest that I am currently an active musician in the greater Austin area that has been adversely impacted by COVID-19, and upon request I will be able to provide proof of either jobs lost as a result of COVID-19 or proof of previous earnings made pre COVID-19 from past performances.

I grant to PeopleFund the right to photograph, videotape me and make recordings of my voice and to use, exhibit, display, broadcast, publish or copyright my image and/or name and/or a recording of my voice in advertisements as it relates to PeopleFund or its affiliates. I agree that all photographs, tapes, recordings and films of me taken by PeopleFund or its affiliates are owned by each as such and that PeopleFund may copyright material containing the same. Do you agree to photo release, inclusion in PeopleFund marketing, and promotion of your business?*

Yes
No

I understand that this program requires a credit check and my credit will be pulled.*

Yes
No

I confirm that I have completed this form truthfully and understand that untruthful answers will prevent me from obtaining funding under this program.*

Yes
No

I will submit necessary documents and information needed when requested, including before and after I receive funding.*

Yes
No

I know that I may be audited to prove that funds under this program were used appropriately. I agree to an audit of the use of funds received.*

Yes
No

By signing below, you agree to all of the representations, authorizations, and certifications as listed in this application.*

Applicant signature

Today's Date*