^{GET READY! Grant Application}

(Please print this form)

Organization Name ___________________________________________________

Address______________________________________________________________

Contact Person for this proposal _______________________________________

Daytime Phone Number _____________________ Fax ____________________

E-mail ___________________________ Today's Date_________________

1. Is the organization chartered by NY State’s Board of Regents? Yes __ No __

2. Is the organization a:

___501C3 ___Branch of local government ___Other?______________________

3. Describe your physical facility:






4. Annual Operating Budget: ___________________

5. Have you applied to the NYSCA Museum Program in the past? Yes ___ No ___

If so, date of last contract________________________________________________

6. Please attach the following:
A) One page description of your organization and the need for planning at this time
B) Mission Statement
C)List of current board members and affiliations
D) Annual Budget or financial report
E) Minutes of your organization's last board meeting