Louisiana Cultural Assests Rescue

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Artist

Business

Educational Institute

Organization

Cultural Economy Foundation

Americans for the Arts Emergency Relief Fund

Tipitina's

Emergency Management Assistance Compact

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Search Organization Submissions

Items marked with an * are required.

Organization: *

Contact Name: *

Address: *

City: *

State: *

Zip: *

Phone Number: *

Email: *

Website:

Cultural Discipline of Organization:
Check all that apply: *

Dance
Design Arts
Folk Life
Literature
Multi-Discipline
Culinary

Media
Music
Theatre
Visual Arts and Crafts
Preservation

Do you have 501c3 designation from the IRS?: *

YES
NO

Are you recognized by the Secretary of State as a non-profit organization?: *

YES
NO

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

Has your 2005-2006 arts 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.:

Do you own or rent your facilities?: *

YES
NO

Were your facilities damaged by the hurricane?: *

YES
NO

If yes, give the estimated damages in $:

Has your organization address changed since the hurricane?: *

YES
NO

Audience numbers pre hurricane:

Audience numbers post hurricane:

Earned Income: *

Pre Hurricane

Post Hurricane

Contributed Income: *

Pre Hurricane

Post Hurricane

Total Income: *

Pre Hurricane

Post Hurricane

Program expenses: *

Pre Hurricane

Post Hurricane

Administrative expenses (including personnel): *

Pre Hurricane

Post Hurricane

Total expenses: *

Pre Hurricane

Post Hurricane

Number of paid staff (pre hurricane): *

Number of paid staff (post hurricane): *

Number of volunteers (pre hurricane): *

Number of volunteers (post hurricane): *

Does your organization have any collaborative partnerships or arrangements with other organizations (non-profit or for-profit)?:

K-12 school groups
Arts organization

University arts organization
For profits

Other:

If yes describe.:

How has the hurricane affected the relationship?:

How would you rate your organizational capacity in the following areas post hurricane?:

board development and engagement
marketing/promotion
identifying and securing staff
public participation in programs
technology capacity
community program development
education program development
facility development and management
partnership and collaboration
financial management and planning
fundraising
grantwriting
review of mission
engagement with new work
retaining qualified associates
evaluation
other:

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

	FEMA
	Small Business Administration
	Others(charities, foundations)

Are you insured?: *

YES
NO

Percent of loss you expect to recover through insurance: *

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