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.
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 |
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* 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.
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.
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.
Has your organization had a single or program-specific audit in the past three years?
Yes
No
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.
Objective 2.1: Promote inclusive engagement across diverse audiences.
Objective 2.2: Support community collaboration and foster civic discourse.
Objective 3.1: Support collections care and management.
Objective 3.2: Promote access to museum and library collections.
Select the program to which you are applying.
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
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
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
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
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
Is your organization a public, tribal, or private nonprofit agency or institution?
Yes
No
Is your organization organized on a permanent basis for essentially educational, cultural heritage, or aesthetic purposes?
Yes
No
Does your organization own or utilize tangible objects and care for such tangible objects?
Yes
No
Does your organization exhibit the tangible objects to the general public in a facility that you own or operate?
Yes
No
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 +
How many days was your institution open to the public during these 12 months?
0 - 119
120 - 249
250 - 365
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
Number of full-time paid institutional staff:
0
1
2
3
4 - 10
11 - 50
51+
Number of full-time unpaid institutional staff:
0
1
2
3
4 - 10
11 - 50
51+
Number of part-time paid institutional staff:
0
1
2
3
4 - 10
11 - 50
51+
Number of part-time unpaid institutional staff:
0
1
2
3
4 - 10
11 - 50
51+
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
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
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
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
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
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Losin, Peter |
File Modified | 0000-00-00 |
File Created | 2021-05-12 |