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* 1. First and Last Name

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* 2. Email address

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* 3. Home Address

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* 4. Total monthly household income

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* 5. Are you an artist in who lives in Frederick County MD? (You must live in Frederick County MD to be eligible for this fund)

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* 6. Which discipline do you practice?

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* 7. Have any of your events been canceled due to the outbreak of COVID-19 also known as Corona Virus? (NOTE: If you had to cancel your gig because you are in an "at risk category", please mark 'yes' your gig was canceled and specify in your event description below.

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* 8. Do you need help covering expenses that you would have been able to cover if your events weren't canceled due to COVID-19?

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* 9. Please describe the event that was canceled.  Be sure to include the DATE and LOCATION of the event as well as the AMOUNT  you were to be compensated for the event.

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* 10. What is the minimum amount of money you need right now to cover your immediate expenses? (Amount cannot exceed $500)

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* 11. Please provide some evidence of your active artistic practice such as a link to your website, a link to your platforms such as SoundCloud or links to Vimeo,  etc (or send pictures of your artwork to info@frederickartscouncil.org with your name)

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