Form IMLS Museum Progra IMLS Museum Progra IMLS Museum Program Information Form FY22

IMLS MUSEUM PROGRAM INFORMATION FORM [Note: This will be a dynamic form so answers to certain questions will determine what questions the applicant sees next.]

PLEASE NOTE: Information contained within this form may be published online or otherwise shared by IMLS. Therefore, please do not include any sensitive, proprietary, or confidential information.

Section 1. Organizational Financial Information

1. Please complete the following table for the Organizational Unit beginning with the most recently completed fiscal year.

Fiscal Year	Total Revenue*	Total Expenses**	Surplus or Deficit

* For nonprofit tax filers, Total Revenue can be found on Line 12 of the IRS Form 990.

** For nonprofit tax filers, Total Expenses can be found on Line 18 of the IRS Form 990.

2. If the Total Revenue amounts declined by more than 15% for any year over year listed OR if there was a deficit of more than 10% of the Total Revenue for two or more years listed above, explain the circumstances in the box below.

3. Were there any material weaknesses identified in your prior year’s audit report?

• Yes

• No

• Not applicable

A material weakness is a deficiency, or combination of deficiencies, in internal control, such that there is a reasonable possibility that a material misstatement of the entity's financial statements will not be prevented, or detected and corrected on a timely basis. If yes, please explain in the box below.

4. Has your organization had a single or program-specific audit in the past three years?

• Yes

• No

Section 2. Agency-Level Goals and Objectives

Select the IMLS agency-level goal that best aligns with your proposed project. Once you have selected a goal, select an associated objective.

• Goal 1: Champion Lifelong Learning

• Objective 1.1: Advance shared knowledge and learning opportunities for all.

• Objective 1.2: Support the training and professional development of the museum and library workforce.

• Goal 2: Strengthen Community Engagement

• Objective 2.1: Promote inclusive engagement across diverse audiences.

• Objective 2.2: Support community collaboration and foster civic discourse.

• Goal 3: Advance Collections Stewardship and Access

• Objective 3.1: Support collections care and management.

• Objective 3.2: Promote access to museum and library collections.

Section 3. Grant Program

Select the program to which you are applying.

o Museums for America

Refer to the Notice of Funding Opportunity for descriptions of the subsequent options and instructions for how to make a selection.

Select one project category:

• Lifelong Learning

• Community Engagement

• Collections Stewardship and Access

o Museums Empowered

Refer to the Notice of Funding Opportunity for descriptions of the subsequent options and instructions for how to make a selection.

Select one project category:

• Digital Technology

• Diversity and Inclusion

• Evaluation

• Organizational Management

o Inspire! Grants for Small Museums

Refer to the Notice of Funding Opportunity for descriptions of the subsequent options and instructions for how to make a selection.

Select one project category:

• Lifelong Learning

• Institutional Capacity

• Collections Stewardship and Access

o National Leadership Grants for Museums

Refer to the Notice of Funding Opportunity for funding ranges and cost-share requirements associated with these project types.

Select one project type:

• Non-research

• Research

• Rapid prototyping

o Museum Grants for African American History and Culture

Refer to the Notice of Funding Opportunity for funding ranges and cost-share requirements associated with these project types.

Select one project type:

• Small project with no cost share required

• Large project with 1:1 cost share required

o Native American/Native Hawaiian Museum Services

Section 4. Museum Profile (Museum Applicants only)

1. Is your organization a public, tribal, or private nonprofit agency or institution?

• Yes

• No

2. Is your organization organized on a permanent basis for essentially educational, cultural heritage, or aesthetic purposes?

• Yes

• No

3. Does your organization own or utilize tangible objects and care for such tangible objects?

• Yes

• No

4. Does your organization exhibit the tangible objects to the general public in a facility that you own or operate?

• Yes

• No

5. What was your institution’s attendance for the 12-month period prior to the application?

• Fewer than 1,000

• 1,000 - 9,999

• 10,000 - 99,999

• 100,000 - 999,999

• 1,000,000 - 9,999,999

• 10,000,000 +

6. How many days was your institution open to the public during these 12 months?

• 0 - 119

• 120 - 249

• 250 - 365

7. Does your organization use a professional staff (i.e., does your organization employ at least one staff member, or the full-time equivalent, whether paid or unpaid, primarily engaged in the acquisition, care, or exhibition to the public of objects owned or used by the organization)?

• Yes

• No

8. Number of full-time paid institutional staff:

• 0

• 1

• 2

• 3

• 4 - 10

• 11 - 50

• 51+

9. Number of full-time unpaid institutional staff:

• 0

• 1

• 2

• 3

• 4 - 10

• 11 - 50

• 51+

10. Number of part-time paid institutional staff:

• 0

• 1

• 2

• 3

• 4 - 10

• 11 - 50

• 51+

11. Number of part-time unpaid institutional staff:

• 0

• 1

• 2

• 3

• 4 - 10

• 11 - 50

• 51+

Section 5. Project Elements

LIFELONG LEARNING

If you are applying in the Lifelong Learning Project Category, select the primary element that is core to your proposed project from the list below. Your response to this question will help us match your application to reviewers with appropriate experience. Check only one.

• Adult Programs

• Digital Media

• Early Learning

• Exhibitions

• Family Programs

• Interpretation

• K-12 Programs, With Schools

• K-12 Programs, Out of School

• Public Programs

COMMUNITY ENGAGEMENT

If you are applying in the Community Engagement Project Category, select the primary element that is core to your proposed project from the list below. Your response to this question will help us match your application to reviewers with appropriate experience. Check only one.

• Audience Evaluation

• Civic Engagement

• Community-Driven Exhibitions and Programs

• Community-Focused Planning Activities

• Community Outreach/Audience Development

INSTITUTIONAL CAPACITY

If you are applying in the Institutional Capacity Project Category, select the primary element that is core to your proposed project from the list below. Your response to this question will help us match your application to reviewers with appropriate experience. Check only one.

• Museum Staff Professional Development

• Institutional Planning

• Audience and/or Program Evaluation

• Organizational Management

COLLECTIONS STEWARDSHIP AND ACCESS

If you are applying in the Collection Stewardship and Access Project Category, select the primary element that is core to your proposed project from the list below. Your response to this question will help us match your application to reviewers with appropriate experience. Check only one.

• Cataloguing, Inventorying, Registration

• Collections Information Management

• Collections Planning

• Conservation Environmental Improvement/Rehousing

• Conservation Survey

• Conservation Treatment

• Database Management

• Digital Asset Management

• Digitization

MATERIAL TYPES

Please identify the material type(s) that will be affected by your project:

• Animals, living

• Animals, preserved

• Architecture

• Books and Paper

• Electronic Media

• Objects

• Paintings

• Photographic Materials

• Plants, living

• Plants, preserved

• Sculpture

• Textiles

• Wooden Artifacts