Louisiana Cultural Assests Rescue

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Items marked with an * are required.

University/College: *

Department/Center/Program: *

Contact Name: *

Address: *

City: *

State: *

Zip: *

Phone Number: *

Email: *

Website:

What cultural discipline does the program target?
Check all that apply: *

Dance
Design Arts
Folk Life
Literature
Multi-Discipline
Culinary

Media
Music
Theatre
Visual Arts and Crafts
Preservation

What is the mission statement for your cultural programming?: *

Has your community programming been affected by the hurricane?: *

YES
NO

Have you had to eliminate programs or do you anticipate eliminating any?: *

YES
NO

If yes, describe.:

Were your facilities damaged by the hurricane?: *

YES
NO

If yes, give the estimated damages in $:

When will you be able to resume using the facility?: *

Have you received hurricane relief assistance? If so, how much and from which agency?:

	FEMA
	Small Business Administration
	Others(charities, foundations)

What is your greatest cultural need at this time?: *