Street Address, Suite #

City

State

Zip Code

Website

Phone

Does your most recently completed fiscal year have an organizational budget under $1.5 million?

YesNo

You are not eligible to apply for this grant.

Is your organization a nonprofit (as reported to the IRS and with an existing EIN) with 501(c)(3) tax-exempt status and registered with the State of Oregon as a charitable organization?

YesNo

You are not eligible to apply for this grant.

If the applicant is a current or past Oregon Humanities grant awardee, has it met all of the grant requirements and is it in good standing with Oregon Humanities?

The applicant is not a current or past grantee.The applicant is a grantee. We are in good standing.The applicant is a grantee. We have not met all grant requirements and are not in good standing.

You are not eligible to apply for this grant.

Have you been debarred or suspended by any federal department or agency?

YesNo

You are not eligible to apply for this grant.

Are you currently delinquent on any federal debt?

YesNo

You are not eligible to apply for this grant.

Is the applicant a fiscal agent, fiscal sponsor, or using either to apply for this grant?

YesNo

You are not eligible to apply for this grant.

Are the individuals who are officially signing this grant application current Oregon Humanities officers or employees, or have they been in those positions within the last year?

YesNo

You are not eligible to apply for this grant.

Please summarize your program in one sentence. If you receive the grant, this sentence will be used to represent your program on our website, in our press release and in other OH publicity materials. (maximum of 30 words)

Examples: "This funding will support monthly youth-led community dialogues exploring identity in our rural community," or; "This funding will support development of a public dialogue connected to our exhibit on Indigenous medicine."

Program description: Please give a full description of the program, including the program content or theme and program activities. Please tell us about your program's goals and intended impact. Please specify if your program will be held in-person, online, or a combination of both. For in-person programs, please specify where they will be held and articulate your backup plan in case in-person gatherings are restricted at the time of your program. Please include any plans you have for program evaluation.

Program planning team: Please describe who is involved in planning and presenting the program, their roles, and how their participation is relevant to the program content.

Program creation and its relationship to participants/audiences: Who is the intended audience(s) for your program and why? How will members of the community that your program is intended for, be involved in your program planning and/or execution? Please describe how you will ensure that this program serves, involves and centers the communities it is intended to benefit. Please describe how this program is timely and relevant to the community, participants and/or audiences your program intends to serve.

Please upload your W-9. Name the file "Organization Name, W-9"

Please upload a copy of your organization’s most recent, board-approved budget, approved/signed by an authorizing official. Please name the file “Organization Name, Board Approved Budget” (.doc/.pdf or .xlsx)

First Name

Last Name

Title

Phone

Ext

First Name

Last Name

Title

Phone

Ext

First Name

Last Name

Title

Submitter's Email

Phone

Ext

Application for 2023 Public Program Grants