APPLICATION TO A CALL FOR AWARDING GRANTS FROM THE ARTISTIC CREATION AND CULTURAL DIVERSITY FUND OF THE CROATIAN PERFORMERS' RIGHTS COLLECTIVE SOCIETY FOR 2019

Please enter the data into the provided fields. Fields marked with an asterisk are mandatory.

Personal identification number: *
Program proposer / grant beneficiary: *
Address:
Telephone:
E-mail: *
Internet address: *
Account number: *
Bank: *
Master number: *
Responsible person (name and surname, telephone, fax, e-mail): *
Contact person (name and surname, telephone, fax, e-mail): *

Programe title / Program units	Planned time and place of event	Planned costs total	Grants: From HUZIP's Fund

TOTAL HUZIP's funds
FINANCIAL PLAN OF THE PROGRAM
Title of program unit: *
Total amount of necessary funds (in HRK): *
PLANNED INCOME	AMOUNT
- own funds: *
- funds from HUZIP's Fund: *
- funds from City budget:
- income from the Croatian Ministry of Culture:
- income from other beneficiaries of the City budget (list the beneficiaries):
- income from sponsors and donors:
- other income(list which):
TOTAl *
PLANNED COSTS
Organization:
Materials, raw materials, technics (everything necessary to execute the program):
Energy (electricity, gas, gasoline):
Telephone, postal and transport services:
Servicing and maintenance services:
Publicity and informacion services:
Utilities:
Rent:
Business trips:
Intellectual and personal services - total:
Author's royalties:
Contracts for work and service:
Student services:
Other:
Representation:
Other non-specified costs:
TOTAl:
PROGRAM / PROGRAM UNIT DESCRIPTION * If the program description does not fit into the provided field, please submit it on a seperate sheet of paper in addition to the printed Application form
HEAD OF PROGRAM / PROGRAM UNIT (name and surname, telephone, fax, e-mail): *