Grants Application What Is Your Full Name Name?* First Stage Name or Business Name Last Please include your Stage Name Example: Jonny JR SmithWhat Is Your Email Address?* What Is The Best Phone Number To Call?*When Is Your Birthday?*DD-MM-YYYYPlease Provide Your Home or Business Address* STREET ADDRESS ADDRESS LINE 2 CITY AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon PROVINCE POSTAL CODE How Did You Hear About Benjamin Verde?*Canadian AffiliateAmerican AffiliateUK AffiliateArtist MemberSearch Engine (Google, Yahoo, Bing)Industry Professional (Word Of Mouth)Please let us know the name of the company or person that told you about Benjamin Verde. We would love to thank them.Please Provide The Email And Phone # Of The Company or Person That You've Hired*Please provide the contact information of the Company or Person that you hired to do your video, recording etc.? Example: John Smith 123 Company Inc John@companyinc.ca (123) 456-7891 Tell Us About Your Project*Just give us a quick explanation of fewer than 140 characters.Contribution Tiers*Emerging Artist or Start-Up Entertainment CompanyEstablished Artist or Entertainment CompanyLess than 3 years experience or More than 10 years industry experience What Is The Desired Amount Of Grant Contribution?*$100.00-$250.00$251-$500.00All grants are approved at Benjamin Verde Incorporated's sole discretion. The recipient is responsible for the taxes based on the value of the grant. Example: Grant $100 Taxes (HST 13%) The recipient pays $13.00What Is Your Reason For Applying For This Grant?*Brand BuilderAudio ProductionOnline RadioVideosOpen BoxWhen Do You Need The Funds?*PLEASE NOTE:: Application Processing Fee must be paid within two days of application otherwise your application will be considered to be withdrawn. Grant recipients must use the awarded grant within 45 days, or the grant will be forfeited. How Much Are You Investing In The Project?*$0.00-$99.00$100.00-$499.00$500.00-$1000.00$1000+What Is Your Weekly Income?*Under $250Between $300-$500Between $500-$1000Over $1000Do You Want To Apply For A Verdefied Grant?*Yes, I am a Member and agree to the additional charge of $5.00- $10.00No Thank YouPLEASE NOTE: Verdefied Grants are made exclusively available to participants of the Benjamin Verde Incorporated FREE ARTIST MEMBERSHIP PROGRAM: (AMP) and Members that have subscribed to the ONLINE ARTIST MANAGEMENT : (OAM)What Is The Amount Of Funding Needed ?Less $500$500 - 1K$1000+How Long Have You Worked For Your Employer?Less than 3 monthsBetween 6-12 monthsOver 12 monthsRequired ID and DocumentsAccepted file types: jpeg, jpg.Only Photo ID is required for Grant applications. Both Photo ID and images of your collateral are required if you are applying for an Artist Advance or Equipment. Only JPEG and JPG formats are supportedTerms and Conditions* I Accept the Terms and Conditions The 48 Hour Payment Policy* I Accept the Terms and Conditions above and agree to make payment for Application Processing Fee (APF) of $10.00 plus applicable taxes within 48 hours after receiving your Benjamin Verde invoice. Additional Documents And Material* I Accept the Terms and Conditions above and agree to provide valid ID, proof of address along with any other documents or information requested within 48 hours after receiving your Benjamin Verde invoice. Funding Eligibility Policy I understand that I MUST purchase one "PAID Consultation" per year or subscribe to OAM for Benjamin Verde funding eligibility. CAPTCHANameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.