A. Applicant Section

Organization Name:

Federal Employer's ID (Last 4 digits only):


Contact Person:


Contact Person's Title:


Address:


City:


State: Zip code:

E-mail Address:


Web site Address:


Telephone (daytime):


County:



Legislative District Numbers (If you don't know your district numbers, click here.)
Iowa House #:  Iowa Senate #:  US Congress #:

Type of Applicant: (select one)
Government
Non-profit Organization
Indian Tribe

Project Information

Project Title:



Project Summary: Describe your project in 2-3 sentences to be used in press releases (~50 words or 500 characters)



Proposed Project Dates (month/day/year):
From to

Was this project in existence prior to the program deadline?
Yes    No

Has this project received funding from the State Historical Society of Iowa, the Iowa Arts Council, or the Iowa Department of Cultural Affairs in the current or previous year?  
Yes    No

If yes, from which grant program(s) did the project receive funding and how much was the grant amount?

Iowa Arts Council Grants:
none Artists in Schools/Communities Residency Grant Artist Project Grant Arts in Education Project Grant Arts Partnership for Achievement Grant Character Counts Grant Conference, Workshops & Forum Grant EZ 123 Grant Folk and Traditional Arts Grant Mini Grant Operational Support Grant Partnership Grant Project Grant for Organizations Public Art Project Grant $
none Artists in Schools/Communities Residency Grant Artist Project Grant Arts in Education Project Grant Arts Partnership for Achievement Grant Character Counts Grant Conference, Workshops & Forum Grant EZ 123 Grant Folk and Traditional Arts Grant Mini Grant Operational Support Grant Partnership Grant Project Grant for Organizations Public Art Project Grant $
Historical Society Grants:
none Certified Local Government Grant Country School House Grant Historical Site Preservation Grant REAP-HRDP Grant $
none Certified Local Government Grant Country School House Grant Historical Site Preservation Grant REAP-HRDP Grant $
Iowa Department of Cultural Affairs Grants:
none Iowa Community Cultural Grant Cultural Enrichment Grant  $

The site in question is: (select one)

Listed on the National Register of Historic Places
Declared eligible by the State Historic Preservation Office for listing on the National Register of Historic Places
A facility in which Iowa's history or the heritage of Iowa's people is interpreted

Is there any Federal involvement in your project? (Federal involvement could include funding, licensing, permitting or other types of assistance.)
If yes, list the name of the Federal agency:




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