Co-Op Press
                 Residency Assistance Grant Program
                              
                         Application
               (please type or print legibly)

Contact information regarding the person completing the
application:

     Name:
     
     Street Address:
     
     City, State, and Zip Code:
     
     Phone Number:
     
     E-mail address:
     
Information regarding the organization applying (if any information is the
same as above, just indicate "same"):

     Name of organization:
     
     
     
     
     Director's name (if applicable):
     
     Street Address:
     
     City, State, and Zip Code:
     
     Phone Number:
     
     E-mail address:
     
     URL for organization (if applicable):
     
     Level of development (check one):
     
     __elementary
     
     __junior high/middle
     school
     
     __high school
     
     __undergraduate
     
     __graduate
     
     __professional
     
     __amateur
     
     Please include a paragraph or two that
     would illuminate the accomplishments of the organization:
     
     
     
     
     

     
     
     
     
     
     
     
     
     
     
     
     
     

     
     
     
     
     

     
     
     
Information regarding the proposed residency (be as
specific as possible):

     Please list the dates for the desired residency (1-5 days):
         
           Choice 1 -


           Choice 2 -



     Please list a composition or compositions of Sy Brandon to be
     performed during the residency:




     Date and Time of Performance during the residency (no sooner than 3 months
     from the application date):
      
            Choice 1 -


            Choice 2 -

     
     Place of Performance:
     
     Seating Capacity of Venue:
     
     Anticipated Audience:
     
     Anticipated Publicity:
     
     
     
     Anticipated Recording:
          __Analog  __ Digital
     
    
     Please include a paragraph expressing what the
     organization hopes to accomplish by having Sy Brandon in residence
     and a description of activities to take place  
     during the residency:
     
     
     
     
     














Final Instructions:

A recording (cassette or CD) of the performers must be
included with this application.

Mail the completed application along with the recording to:

     Co-op Press
     P.O. Box 204
     Wrightsville, PA 17368-0204
     
I have read the guidelines regarding this grant proposal,
agree to abide by these guidelines. The information provided 
in this application is correct to the best of my knowledge.



__________________________________________        _________
Signature of person completing application        date