3135-0112 NEA Organization and Project Profile Form

OMB No. 3135-0112
Expires TBD

National Endowment for the Arts
Organization & Project Profile Form
PART 1: APPLICANT
* Legal Name:
Popular name (if different):
If your organization uses a popular name that is different from the legal name, note that name in the space provided.
* Total organizational operating expenses for the most recently completed fiscal year: $
Enter the total operating expenses for your organization. If you are the lead applicant for a consortium, provide this
information for your own organization. If you are a parent organization, provide this information for the component on
whose behalf you are applying. Unaudited figures are acceptable. This field is required.
* For year ending (Month/Year, e.g., 00/0000):
MM/YYYY
Enter the fiscal year end date (MM/YYYY format) for your organization's total operating expenses. This field is
required.
----------------------------------------------------------------------------------------------------------------------------------------------------------* For this application, the applicant is serving as a:
Choose “Lead Member of a Consortium” or “Parent of a Component” if applicable; otherwise choose “Not Applicable”.
LC: Lead Member of a Consortium
IC: Parent of a Component
NA: Not Applicable
* For:
List the name of the one primary consortium partner or the component on whose behalf you are applying.
-----------------------------------------------------------------------------------------------------------------------------------------------------------

APPLICANT ORGANIZATION STATUS
Select the one item that best describes the legal status of the applicant organization.
02: Nonprofit Organization

05: State Government

07: County Government

08: Municipal Government

09: Tribal Government

99: None of the Above

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OMB No. 3135-0112
Expires TBD

National Endowment for the Arts
Organization & Project Profile Form
APPLICANT ORGANIZATION DESCRIPTION
The following codes work in conjunction with Organization Discipline codes below (e.g., select “Performing Group”
here and “Theater” below to indicate that your organization is a theater company). Select the one item that best
describes the organization.
72
15

Artists’ Community, Arts
Institute, or Camp
Arts Center
(e.g., a multi-purpose arts
facility)

16

Arts Council or Agency

28

Historical Society

07

Performance Facility

29

Humanities Council or Agency

03

Performing Group

12

Independent Press

47

Presenter/Cultural Series Org.

27

Library

35

Religious Organization

13

Literary Magazine

19

School District

11

Media – Film

48

School of the Arts

(e.g., a cinema or film

50

Social Service Organization

(includes regional arts
organizations)
17

Arts Service Organization
(includes statewide

exhibitor)
TBD

Media - Internet

45

Media – Radio

assemblies)
26

College or University

32

Community Service
Organization

46

(a governmental or private agency,
e.g., a public housing authority)
18

Union or Professional Assn.

(e.g., a NPR station)

(includes artists’/designers’ guilds,

Media – Television

societies, etc.)

(e.g., a PBS station)

(a non-arts service

08

Museum - Art

organization, e.g., youth

09

Museum - Other

99

None of the Above/Please specify:
____________________________

center or YMCA)
14

Fair or Festival

30

Foundation

10

Gallery/Exhibition Space

38

Government
(state, county, local, or tribal)

APPLICANT ORGANIZATION DISCIPLINE
Choose the one discipline that is most relevant to your organization.
72: Artist Communities

52: Literature

28: Musical Theater

51: Arts Education

62: Local Arts Agencies

36: Opera

33: Dance

34: Media Arts

54: Presenting

42: Design

44: Museums

32: Theater

55: Folk & Traditional Arts

31: Music

41: Visual Arts
99: None of the Above/Please specify:

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OMB No. 3135-0112
Expires TBD

National Endowment for the Arts
Organization & Project Profile Form
PART 2: PROJECT
PROJECT FIELD / DISCIPLINE
Choose the one discipline that is most relevant to your project. This selection will aid the Arts Endowment’s
application review. This field is required.
If your project field is Arts Education, please select two disciplines: Arts Education, and the discipline that is most
relevant to your project.
72: Artist Communities

52: Literature

28: Musical Theater

51: Arts Education

62: Local Arts Agencies

36: Opera

33: Dance

34: Media Arts

54: Presenting

42: Design

44: Museums

32: Theater

55: Folk and Traditional Arts

31: Music

41: Visual Arts

CATEGORY

INTENDED OUTCOME
In the first column, select the outcome that best describes the primary intent of your project. You may also select a
secondary outcome, in the second column, if a significant portion of your project is aligned with a second NEA
outcome. For some categories, the Arts Endowment may designate a single outcome; see the application guidelines
for more information. Make no more than one selection in each column.
Primary
Outcome

Secondary
Outcome

The Portfolio of American Art is Expanded
Americans Throughout the Nation Experience Art
Americans of All Ages Acquire Knowledge or Skills in the Arts
American Communities are Strengthened Through the Arts

PROJECT BUDGET SUMMARY (All fields are required.)
Amount Requested:

$

Enter the dollar amount requested. This figure must agree with “Amount Requested from the Arts Endowment” in
Item 1 of the Project Budget Form.

+ Total Project Match:

$

Enter the dollar amount of total matching funds for this project. This must agree with Item 2 of the Project Budget
Form.

= Total Project Costs:

$

Enter the total project costs [Amount Requested + Total Project Match]. This must agree with Item 6 of the Project

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OMB No. 3135-0112
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National Endowment for the Arts
Organization & Project Profile Form
Budget Form.

PROJECT ACTIVITY TYPE
Using the list below, enter in the first box the code of the activity that describes the primary project activity. You may
also enter a secondary activity type in the second box if it represents a significant portion of your project activity.
Primary Activity Type:
25

Apprenticeship

12

Arts Instruction
Includes lessons,
classes, and other
means to teach
knowledge of and/or
skills in the arts

04

Artwork Creation
Includes media arts,
design projects, and
commissions

02

Audience Services
(e.g., ticket
subsidies)

36

Broadcasting
via TV, cable, radio,
the Web, or other
digital networks

Secondary Activity Type:
24 Distribution of Art
(e.g., films, books,
prints; do not include
broadcasting)

18

Repair/Restoration/
Conservation

19

Research/Planning
Includes program
evaluation, strategic
planning, and
establishing partnerships

20

Residency - School
Artist activities in an
educational setting

21

Residency - Other
Artist activities in a
non-school setting

22

Seminar/Conference

9B Presenting/Touring

30

Student Assessment

29

34

Technical Assistance
with technical/
administrative functions

35

Web Site/Internet
Development
Includes the creation
or expansion of Web
sites, the development
of digital art collections,
interactive services
delivered via the Internet,
etc.

28

Writing About Art/
Criticism

99

None of the Above/Please specify:

06 Exhibition
Includes visual arts,
media arts, design, and
exhibition development
08 Fair/Festival
09 Identification/
Documentation
(e.g., for archival or
educational purposes)
13

33

05

Building Public
Awareness
Activities designed to
increase public
understanding of the arts
or to build public support
for the arts
Concert/Performance/
Reading
Includes production
development

31 Curriculum
Development/
Implementation
Includes the design
and distribution of
instructional
materials, methods,
evaluation criteria,
etc.

Marketing

Professional
Development/
Training
Activities enhancing
career advancement

14

Professional
Support:
Administrative
Includes consultant
fees

15

Professional Support:
Artistic
(e.g., artists’ fees,
payments for artistic
services)

17 Publication
(e.g., books, manuals)
16 Recording/Filming/
Taping
(e.g., to extend the
audience for a
performance through
film/tape; do not include
archival projects)

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OMB No. 3135-0112
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National Endowment for the Arts
Organization & Project Profile Form
INDIVIDUALS BENEFITING
Provide data for individuals expected to directly benefit from the project. Leave blank any items that are not
applicable or for which supportable estimates do not exist.
Individuals Directly Involved in Implementing the Project
Enter the number of individuals; these individuals must be included in the project
budget. Do not double-count. Audience/ Attendees/ Participants/ Learners should
be accounted for in the next table.

Number

Artists
Teachers
Others
TOTAL

If you intend to use social
and/or other new media to
reach people, please check the
appropriate column below.

Audiences/Attendees/ Participants/Learners
Enter the number of people you anticipate reaching through each method as
applicable. Do not double-count.

Adults
Children/Youth
(younger than 18)
TOTALS

“Live” Arts Experience

Broadcast

(where people visit a
venue – whether alone
or in a group - to view or
participate in an arts
activity. Includes
exhibits, performances,
and film screenings
before an audience;
excludes audiences that
view or participate
through transmission.)

(TV, radio, cable)

Distribution of
Social Media
Other New
Physical
Media
(e.g., Facebook,
Materials
Twitter, wikis) (e.g., websites,
(e.g., CDs,
webcasts,
DVDs, books)
eBooks and
other
downloads,
streaming,
mobile phone
apps)

#

##
#
#

#

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OMB No. 3135-0112
Expires TBD

National Endowment for the Arts
Organization & Project Profile Form
POPULATION DESCRIPTORS
From each section, select the descriptor that best describes the primary population expected to benefit from the
project during the period of support. These responses should refer to populations reached directly, rather than
through broadcasts or Internet programming.

Race / Ethnicity:

Age (Range):

N

American Indian / Alaska Native

01A

Pre-Kindergarten (0-5 years)

A

Asian

01D

K-12 (6-18 years)

B

Black / African American

01C

Young Adults (19-24 years)

H

Hispanic / Latino

01B

Adults (25-64 years)

P

Native Hawaiian / Other Pacific Islander

01

Older Adults (65+ years)

W

White

99

No Single Group

99

No Single Group

Geography:

Communities:

09I

International

TBD

Urban

TBD

Multiple States

09D

Rural

TBD

Statewide

TBD

Suburban

TBD

City / County

99

No Single Group

From the section below, select all of the descriptors that best describe the primary population expected to benefit
from the project during the period of support. These responses should refer to populations reached directly, rather
than through broadcasts or Internet programming.

Underserved / Distinct Groups:
TBD

Individuals with Disabilities

TBD

Individuals in Institutions (include people living in hospitals, hospices, nursing homes, assisted care
facilities, correctional facilities, and homeless shelters)

TBD

Individuals with Low Income

TBD

Individuals with Limited English Proficiency

TBD

Military Veterans/Active Personnel

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