3135-0112 Geographic Location of Project Activity

OMB #: 3135-0112
Expires 11/30/07

NATIONAL ENDOWMENT FOR THE ARTS
GEOGRAPHIC LOCATION OF PROJECT ACTIVITY
Instructions: To assist the Arts Endowment in reporting to Congress on the geographic location of grantsupported activities, complete and return one copy of this form (via mail or fax) to the address below within
30 days of receiving your award letter or with your first payment request, whichever comes first. No grant
funds will be released until this information is received.
Grants & Contracts Office/Geographic Location Project
FAX: 202-682-5609/5610
National Endowment for the Arts
1100 Pennsylvania Ave., NW, Room 618, Washington, DC, 20506
Grantee Name:

Grant #:

Address:

Award Amount:

$

Note: In responding to the following, provide information about places where grant-supported activities will
occur during the grant period (including areas reached through touring, broadcast, etc.), not places from
which audiences may be drawn. Questions? Call 202/682-5585.
A. Check the one item that best describes where project activity for this grant will take place:
In one city/county.
In more than one city/county but within one state (include statewide activity).
In more than one state but within the same metropolitan area (e.g., New York City/New Jersey).
In more than one state/metropolitan area, but within the same geographic region (e.g., Western states).
In more than one state and more than one geographic region (include nationwide activity).
Outside the United States and its jurisdictions.

B. List locations where project activity for this grant will take place. Please provide this information to the
best of your ability at this time, including the complete address (city/state/zip) for each venue. Follow the
enclosed sample format or attach any similar listing of project activities and their locations.
GRANTEE RESPONSE:

Attach separate sheet(s) as necessary, indicating the grantee name and grant number at the top of each
page.
Activity (e.g. who, what, when)
Location(s)

C. Contact Person for further geographic location information (please print or type):
Name:
Telephone:
Title:
E-mail:

OMB #: 3135-0112
Expires 11/30/07

Geographic Location of Project Activity
SAMPLE FORMAT

Example 1

Activity (e.g. who, what, when)

Location(s)

Performance by Lone Star Dance
Company, 9/1/06 (full company)

Congress Theater
1001 Congress Street
Austin, TX 78701

In-school lecture/demo by choreographer
J. Smith and Lone Star Dance Company
touring ensemble, 10/06

Audie Murphy High School
1500 N. Alamo St.
San Antonio, TX 78215
Additional school (TBA)
San Antonio, TX

Example 2

Example 3

Art Today traveling exhibition
Sept.- Dec. ‘06

San Francisco State Univ. Art Museum
1600 Holloway Ave.,
San Francisco, CA 94132

March - July ‘07

Museum of Fine Art
1200 22nd Ave., S.
Seattle, WA 98168

‘07 New Jazz radio broadcasts

WNYC (New York, NY)
WABC (Hartford, CT)
WKYZ (Burlington, VT)
(Alternatively, attach a station carriage list)