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申请表格

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一资助- 申请表格
1 Year Grant - Application Form 音,跨媒介多媒介,电影及媒体,舞蹈,戏曲,戏剧Music, Art, Film Media Arts,Dance, Xiqu, Drama(须於二二月二十八日下午时三十分或以前提交)
(valid only for applications submitted on or before 6:30pm, 28 February填写申请表前、请细心阅《200607一资助邀请计划书》的申请条款.
请用黑笔填写申请表格.Before filling in this form, please read the Application Conditions ofthYear Grant Invitation for Proposals.
Please use black ink to fill in the application form.
申请团体Name of Applicant:申请资助额Amount of grant sought本局专用For Official Use Only收表日期Date Received 所属界别Artform 初核人员Processing Officer申请人编号Applicants Number 档案编号File Number 覆核人员Supervising Officer注意事项Notes
1 本局将影印及派发填妥的申请表格及计划书予评审小组审批.其他的考性质或宣传或推广资将由艺发局视乎情况而决定是否影印及派发予评审小组.The completed Application Form and the proposal will be copied and distributed to the Selection Panel forassessment. Other reference materials or publicity or promotional materials will be copied and distributed to theSelection Panel at the discretion of the HKADC.
2. 提交申请前须确定:申请表格已由申请团体的最高负责人亲自签署,已盖上注册有限公司的印章已填妥的申请表格及其他附件已由申请者自影印备存
Please ensure that:
the Application has been signed by the head of organisation of the Applicant, and the official chop has beenaffixed;photocopies of the completed Application and its supporting documents have been made and retained by theApplicant for reference.
3. 艺发局认为申请表资足及欠缺上所需附件,本局有权处该项申请.
If the information supplied in the Application Form is insufficient in the view of the HKADC or the documents are missing, the HKADC reserves the right not to process the application.
4. 申请表及所有附件须以密件形式递交本局.信封面须注明「一资助」申请.
The completed Application Form and all supporting documents must be submitted to the HKADC under and marked One-year Grant on the envelope.
5. 如亲身递交表格,须於截止日期2006 2月28日下午6时30分前投入设於香港皇后大道中181号22 香港艺术发展局内的收集箱.邮寄表格以邮戳为凭.逾期递交的申请将获受.Applications submitted in person must be deposited in the collection box located at Hong Kong Arts 22F, 181 Queens Road Central, Hong Kong by 6:30p.m. on the closing date for application 28 February,
2006. Submission by post will only be accepted if postmarked no later than the deadline. No late applications will be accepted.
6. 本局接受传真,经互网电邮传递或以其他电子形式提交的申请表格.
The HKADC does not accept applications sent by fax or email or in any digital form.
申请者自仿制的申请表.Application Form can be downloaded from the HKADCs website The HKADC made on photocopy of valid application form, but does not accept imitated forms produced by theapplicant.如有任何查询,欢迎致电本局、电话戏剧戏曲音,跨媒介多媒介及舞蹈)或电影及媒体艺术).For enquiries, please contact the HKADC atfor drama, atfor xiqu, atfor and dance, or atfor film and media arts applications.
3 香港艺术发展局Hong Kong Arts Development Council 200607「一资助」申请书音,跨媒介多媒介艺术,电影及媒体,舞蹈,戏曲,戏剧Year Grant ARTS, FILM MEDIA ARTS, DANCE,XIQU, DRAMA申请团体资Applicant Information申请团体名称(英文)Name of Applicant (English)申请团体名称(中文)Name of Applicant (Chinese)办事处地址Office address注册地址(如与上述同)Registered address(if different from above)机构之法定地位Legal status of organisation络人姓名及职衔Name title of contact person(s)络电话Contact telephone no.传真号码Fax no.声明及保证DECLARATION AND WARRANTY(a) 我们现确认本申请乃是在收悉艺发局於2006 1月16日所发出的《200607一资助邀请计划书》后而作出的回应.我们已细阅、完全明白及同意其内容以及所载述的申请条款,并确认本申请受有关的申请条款所约束.We hereby confirm that this Application is made in response to the Invitation for Proposal for the One year Grantissued by the Hong Kong Arts Development Council on the 16th day of January, 2006 and subject to theApplication Conditions therein and received by us and which we have read and fully understand and agree as ifset out herein.
(b) 我们特此声明及保证、申请表上所有资全部属实.如有改、须事先获艺发局书面同意.
We declare that all information given in this application form and attached documents are true and correct to thebest of our knowledge and will not be amended without the written approval of the HKADC.
(c) (如适用)我们出所有与本申请的艺发局委员,艺术界别顾问,审批员及职员姓名:
We hereby list out all current ADC Member(s), Artform Advisor(s), Examiner(s) and staff who will be involvedin this application (if any):
机构印章Official Chop主席签名Signature of Chairman :
以大楷填写姓名Name in block letters :总政经签名Signature of Manager :
日期Date :香港艺术发展局Hong Kong Arts Development Council计划节目名称Project Programme Name请另纸详述节目内容及主要与人员Please introduce each project and the key onaseparate sheet日期及时间Date Time观众加者者人No. of of the Project开支Expenditure收入Income
计划合约人员酬:Salaries for Project Staff
票房销售学费:Box Fee主办合办单位
制作费:Production Cost
其他(请详述) :Others(please specify)每个计划节目的举次演出场No. of times each is performedheld注Note 1
整体开支:Total Expenditure
整体收入:Total IncomeMUSIC, ARTS, FILM MEDIA ARTS, DANCE, XIQU, DRAMA音,跨媒介多媒介,电影及媒体艺术,舞蹈,戏曲,戏剧场地Venue注Note1如该计划节目是由一系的项目组成( 如放映工作坊课程),请注明项目目.
If the consists ofaseries of please state the number of sub-units.
注Note2This section lists expenditure for each project. They must NOT overlap with the administrative expenses included in
此部份所的是每个计划的支出、可与表格的政开支有重叠.
200607「一资助」申请书Year Grant Application表格FORM 1
200607 计划Programme 请依活动日期顺序填写. Please list projects in ascending order of dates.
计划预算Project Budget注Note 2请按需要复印此表Please duplicate if required
计划节目总:Total no.
计划总开支:Overall
计划总收入:Income
观众加者者总 of All Projects音,跨媒介多媒介,电影及媒体艺术,舞蹈,戏曲,戏剧Year Grant ARTS, FILM MEDIA ARTS, DANCE, XIQU, DRAMA 表格FORM2董事局成员名单List of Board Members姓名Name职衔Capacity全职工作岗位( 有)有关背景及经验Full-time Job (if any)Relevant Background and Experience与贵团受薪工作人员有亲属或其他密关系,请明.Please declare if there is any family relationship orclose relation with any paid employees董事局的职责及对董事局的期望 and Expectations on the Board表格FORM 3估计Estimate港元HK占总收入百分比% of total income差Variance(%)差高出10,请详加解释.Please explain if variance is over 10.
总收入Total Income:F. 其他政府机构主办赞助节目Other hired engagements from the GovernmentG. 其他非政府机构主办赞助节目收费Hired engagements other than the GovernmentB. 票房收入Box office IncomeC. 销售收入Sales IncomeD. 学费Tuition FeeE. 康文署主办赞助节目Hired engagements from LCSDA. 香港艺术发展局Hong Kong Arts Development Council(1) 收入INCOME:艺团营运收支预算Operation Budget资助最新估计172005-
3062006 Latest Estimate占总收入百分比% of %字yearly figure字yearly figureMUSIC, ARTS , FILM MEDIA ARTS, DANCE, XIQU, DRAMAH. 捐赠及赞助Donations SponsorshipI. 其他(如顾问费、服装、道具及场地租赁、请详述)
Others (such as consultation fee, costume, props and venuerental; please specify)
差的计算法Variance in percentage should be calculated as= (Items 项目(2) 支出EXPENDITURE:占总支出百分比% of 计划总开支Total Project Expenditure即於表1的总额Use total expenditure in Form1小计Sub-total for (A) :
(B) 个人酬Personal Emoluments
1. 工资- 即附表5 字上的总额Salaries - use total in Form5
2. 强积及其他津贴- 即附表5 字上的总额Mandatory Provident Fund and - use total in Form5小计Sub-total for (B) :
(C) 个别计划以外的市场及推广费(请详述)Non-project based Marketing specify)
如:印刷费、广告及推广费或公共关系开支e.g. Printing, Advertisement Promotion orPublic Relations Expenses小计Sub-total for (C) :表格FORM 4艺团营运开支预算Operation Budget最新估计资助(2) 支出EXPENDITURE (contd):
(D) 资本支出(请详述)Capital Expenditure (Please specify)
如: 器材, 家俱, 及其他设备e.g. Equipment, Furniture, Fixture 小计Sub-total for (D) :
(E) 个别计划以外的政开支Non-project Based Administration Costs
1. 邮费及文具Postage and Stationery
2. 水电及杂项Utilities and Sundry Expenses
3. 保养及维修Maintenance Repair
4. 办公室及贮物所租务费用差饷及管费Management Fee, Rent Rate for OfficeStores
5. 政人员交通费Administrators travelling
7. 师及核费Legal and audit fees
8. 其他(请详述)Others (Please specify)
小计Sub-total for (E) :
(F) 其他支出(请详述)Other Expenditure (Please specify)
小计Sub-total for (F) :总支出Total expenditure (ABCDEF)
MUSIC, ARTS, FILM MEDIA ARTS, DANCE, XIQU, DRAMA 表格FORM5长期雇员名单List of Permanent StaffPost Title职位持有人姓名Name of PostHolder全职或兼职性质Full-time orPart-time有关学及经验Relevant Qualifications and Experience月薪MonthlySalary全强积其他津贴 Benefitsfor the year请估计从计划获取收入Please estimate amount ofother income from Projects

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