Form OMS PIF 1 OMS PIF 1 IMLS Museum Program Information Form

IMLS MUSEUM PROGRAM INFORMATION FORM
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
a. Please complete the following table for the Organizational Unit for the three most recently
completed fiscal years.
Fiscal Year

Total Revenue*

Total Expenses**

Surplus or Deficit

[NOTE: All fields are required. The FY column should accept numbers only; the other fields should accept
money (decimal, two places). Value in surplus/deficit calculated = revenue minus expenses.]
* 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.
b. If you had a budget surplus or deficit greater than 10% of your annual operating budget for two or
more of the three fiscal years listed above, please explain the circumstances of this surplus or
deficit in the box below. [NOTE: optional]

c. Were there any material weaknesses identified in your prior year’s audit report? [NOTE: required]
o Yes [511]
o No [512]
o Not applicable [516]
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. [NOTE:
required if 'Yes' selected above; otherwise not.]

d. Has your organization had an A-133 audit in the past three years? [NOTE: required]
o Yes [514]
o No [515]

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, please select an associated objective. [NOTE: required. The three lists of
objectives/subcategories should be hidden by default, and when someone selects one of the three toplevel categories (goals), the list of its subcategories (objectives) should appear. Applicant must select
one subcategory/objective.]
o Promote Lifelong Learning [329]
o
o
o
o

Early, Digital, Information, Health, Financial, Media, Civic and Other Literacies [540]
Cross-disciplinary and Inquiry-based Learning Methods [541]
Continuous Learning for Families and Individuals with Diverse Backgrounds and Needs
[542]
Distinctive Role of Museums and Libraries as Trusted Sources of Information [543]

o Build Capacity [330]
o
o
o
o

Recruitment, Training, and Development of Library and Museum Workforces [544]
Share and Adopt Best Practices and Innovations [545]
Identify Trends to Help Organizations make Informed Decisions [546]
Serve as Trusted Spaces for Community Engagement and Dialogue [547]

o Increase Public Access [331]
o
o
o
o

Support Stewardship of Museum and Library Collections [519]
Tools, Technology, and Training Enabling Discovery and Use of Collections and
Resources by All [520]
Policies and Partnerships to Address Access Barriers to Collections, Programs, and
Information [521]
Increased Access to Knowledge through Effective Communications [522]

Section 3. Grant Program
Refer to the Notice of Funding Opportunity for descriptions of these options and instructions for
making selections. [NOTE: the program-level selection is optional; but if someone selects a program, she
must make a selection from the radio button list(s) under that program. There are no categories that
correspond to the program selections; these radio buttons are only used to make it possible to require
selections here and in section 5 below. See note to developers in section 5.]

o Museums for America
Select one project category:
o Lifelong Learning [455]
o Community Anchors and Catalysts [456]
o Collections Stewardship and Public Access [457]

o Museums Empowered
Select one project category:
o Digital Technology [459]
o Diversity and Inclusion [460]
o Evaluation [461]
o Organizational Management [462]

o Inspire! Grants for Small Museums
Select one project category:
o Lifelong Learning [506]
o Community Anchors and Catalysts [507]
o Collections Stewardship and Public Access [508]

o National Leadership Grants for Museums
[Note: a selection from both radio-button lists is required if the program is selected.]
Select one project category:
o Collections Care and Public Access [464]
o Data, Analysis, and Assessment [465]
o Digital Platforms and Applications [509]
o Diversity and Inclusion [466]
o Professional Development [467]
Select one funding level:
o Non-research, $50,000-$1,000,000 [469]
o Research, $50,000-$1,000,000 [470]

o Rapid prototyping, $5,000-$50,000 [471]

o Museum Grants for African American History and Culture
Select one funding level:
o $5,000-$50,000 [473]
o $50,001-$250,000 [474]

o Native American/Native Hawaiian Museum Services
Section 4. Museum Profile (Museum Applicants only)
[Note: all optional.]
a. Is your organization a public, tribal, or private nonprofit agency or institution?
o Yes [336]
o No [337]
b. Is your organization organized on a permanent basis for essentially educational, cultural heritage,
or aesthetic purposes?
o Yes [333]
o No [334]
c. Does your organization own or utilize tangible objects and care for such tangible objects?
o Yes [339]
o No [340]
d. Does your organization exhibit the tangible objects to the general public in a facility that you own
or operate?
o Yes [342]
o No [343]
e. What was your institution’s attendance for the 12-month period prior to the application?
o
o
o
o
o
o

Fewer than 1,000 [345]
1,000 - 9,999 [346]
10,000 - 99,999 [347]
100,000 - 999,999 [349]
1,000,000 - 9,999,999 [350]
10,000,000 + [348]

f. How many days was your institution open to the public during these 12 months?
o 0 - 119 [358]
o 120 - 249 [359]
o 250 - 365 [360]
g. Does your organization use a professional staff (i.e., does your organization employ at least one
staff member, or the fulltime equivalent, whether paid or unpaid, primarily engaged in the
acquisition, care, or exhibition to the public of objects owned or used by the organization)?
o Yes [362]
o No [363]
h. Number of full-time paid institutional staff:
o
o
o
o
o
o
o

0 [365]
1 [366]
2 [367]
3 [368]
4 - 10 [493]
11 - 50 [494]
51+ [495]

i. Number of full-time unpaid institutional staff:
o
o
o
o
o
o
o

0 [370]
1 [371]
2 [372]
3 [373]
4 - 10 [496]
11 - 50 [497]
51+ [498]

j. Number of part-time paid institutional staff:
o
o
o
o
o
o
o

0 [375]
1 [376]
2 [377]
3 [378]
4 - 10 [499]
11 - 50 [500]
51+ [501]

k. Number of part-time unpaid institutional staff:

o
o
o
o
o
o
o

0 [380]
1 [381]
2 [382]
3 [383]
4 - 10 [502]
11 - 50 [503]
51+ [504]

Section 5. Project Elements (Museums for America and Inspire! Grants for Small
Museums only)
[NOTE: If applicant selected 'Lifelong Learning' under either Museums for America or Inspire! (section 3
above), then a selection under 'Lifelong Learning' is required below; if applicant selected 'Community
Anchors and Catalysts', then a selection under 'Community Anchors and Catalysts' is required below; if
applicant selected 'Collections Stewardship and Public Access', then a selection under 'Collections
Stewardship and Public Access' is required below. Otherwise, these are not required.]
Your response to this question will help us match your application to reviewers with appropriate
experience. Make your choice under the project category that you selected in Section 3 (Grant
Program).

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. Check only one.
o
o
o
o
o
o
o
o
o

Adult Programs [384]
Digital Media [385]
Early Learning [386]
Exhibitions [387]
Family Programs [477]
Interpretation [389]
K-12 Programs, With Schools [390]
K-12 Programs, Out of School [391]
Public Programs [392]

COMMUNITY ANCHORS AND CATALYSTS
If you are applying in the Community Anchors and Catalysts Project Category, select the primary
element that is core to your proposed project from the list below. Check only one.
o Audience Research and Evaluation [393]
o Civic Engagement [394]

o
o
o
o

Community-Driven Exhibitions and Programs [395]
Community-Focused Planning Activities [396]
Community Outreach/Audience Development [397]
Digital Media [398]

COLLECTIONS STEWARDSHIP AND PUBLIC ACCESS
If you are applying in the Collections Stewardship and Public Access Project Category, select the
primary element that is core to your proposed project from the list below. Check only one.
o
o
o
o
o
o
o
o
o
o

Cataloguing, Inventorying, Registration [399]
Collections Information Management [400]
Collections Planning [401]
Conservation Environmental Improvement/Rehousing [402]
Conservation Survey [403]
Conservation Treatment [404]
Curation [405]
Database Management [406]
Digital Asset Management [407]
Digitization [408]

MATERIAL TYPES
Please identify the material type(s) that will be affected by your project:
[NOTE: This checkbox list should allow multiple selections. Not required.]
□
□
□
□
□
□
□
□
□
□
□
□
□

Animals, living [409]
Animals, preserved [410]
Architecture [411]
Books and Paper [412]
Electronic Media [413]
Objects [414]
Paintings [415]
Photographic Materials [416]
Plants, living [417]
Plants, preserved [418]
Sculpture [419]
Textiles [420]
Wooden Artifacts [421]