Records Request Form

Complete and submit this form in order to obtain copies of Mid-America Arts Alliance records (i.e. panel or field review comments, grantee information, presenter lists). Information provided through this service is meant for informational purposes only.

Choose that which best reflects the applicant's relationship with M-AAA:

How did you learn about M-AAA?

M-AAA website or communicationM-AAA Facebook or TwitterArkansas Arts Council website or communicationKansas Creative Industries Commission website or communicationMissouri Arts Council website or communicationNebraska Arts Council website or communicationOklahoma Arts Council website or communicationTexas Commission on the Arts website or communicationOther

REQUESTER INFORMATION

Organization Legal Name

This is the Organization's name as it appears on its Federal IRS 501(c)3 Determination Letter.

First Name

Last Name

Title

Street Address

City / Town

State

Zip Code

Phone Number

Fax Number

Requester Email Address

Organization or Requester Website

Choose the category that best describes the Requester's legal status

Choose the Requester's primary discipline area of work in the arts.

Select the Applicant's art practice in general, which may not necessarily be the same as that involved in this project.

INFORMATION REQUESTED

Presenter Grantee ListOther Information

What Other Information do you seek?

CERTIFICATION

By virtue of submitting this form and checking the box below, the individual certifies that all information contained in this request is true.

The individual certifies that the records provided will be used for informational purposes only.

Records derived from this request will not be sold, given or otherwise made available to any person or firm for the purpose of selling or offering for sale any property or service.

Misuse of information obtained through this request could render the individual and/or their organization ineligible for access to, participation in, and/or underwriting through programs offered by M-AAA.

CERTIFIED

Certifier First and Last Name

Certifier Email Address

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Contact Information