INITIAL PROJECT INFORMATION:
1. Type of grant
(select only one):
The Great Michigan
Read
Planning
Guest Speaker
Reading/Discussion
Program
2. Project title
3. Project Dates:
start -
Jan
Feb
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Apr
May
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Nov
Dec
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end
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Jan
Feb
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Nov
Dec
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2009
4.
Project Abstract (summarize project activities, focusing on
the program's humanities content and format).
5.
Sponsoring Organization (Must be a Michigan-based, nonprofit
organization) :
Organization Name:
E-Mail:
Address:
City:
Zip:
County (not Country):
Phone :
Fax :
US Congressional
District #:
MI House:
MI Senate:
6.
Project Director (Note: the same person cannot serve as both
fiscal officer and project director):
Name:
Title:
E-Mail:
Address:
City:
Michigan
Canada
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
D.C.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
N. Carolina
N. Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
S. Carolina
S. Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
W. Virginia
Wisconsin
Wyoming
Zip:
Phone :
Fax :
7.
Fiscal Officer (Note: the same person cannot serve as both fiscal
officer and project director):
Name:
Title:
E-Mail:
Address:
City:
Michigan
Canada
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
D.C.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
N. Carolina
N. Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
S. Carolina
S. Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
W. Virginia
Wisconsin
Wyoming
Zip:
Phone :
Fax :
8.
Authorizing Officer (For sponsoring organization's use if necessary):
Name:
Title:
E-Mail:
Address:
City:
Michigan
Canada
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
D.C.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
N. Carolina
N. Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
S. Carolina
S. Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
W. Virginia
Wisconsin
Wyoming
Zip:
Phone :
Fax :
9.
Schedule of Project Activities (Identify all activities that
require Council funds)
*Most programs funded by Michigan Humanities Council
are free to the public. The Council discourages charging for programs
if fees limit public participation.
Date:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1
2
3
4
5
6
7
8
9
10
11
12
13
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31
2007
2008
2009
Time:
Activity:
Location:
Fee:*
Date:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1
2
3
4
5
6
7
8
9
10
11
12
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30
31
2007
2008
2009
Time:
Activity:
Location:
Fee:*
Date:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1
2
3
4
5
6
7
8
9
10
11
12
13
14
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16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2007
2008
2009
Time:
Activity:
Location:
Fee:*
10 -A. Expected Outcome - Planning
Grants Only (Describe the end result of your planning activities)
10-B. Promotion and Anticipated Audience - Reading/Discussion
or Guest Speaker Program Grants Only (Describe
your publicity plans and expected audience size and composition.
Programs should be held in facilities that are accessible to physically
challenged individuals to allow the broadest possible participation.)
11. Humanities Professional's Name and Title (The
Council defines a humanities professional as anyone with a master's
degree or higher in a traditional humanities discipline, museum/library
professionals or tradition bearers. Refer to the Council's Directory
of Humanities Professionals or contact Council staff for assistance
in identifying a professional. Please submit additional information
by fax, mail, or email to provide necessary information for each
and every scholar participating in your project.)
Name:
Organization/Institution:
E-Mail:
Address:
City:
Michigan
Canada
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
D.C.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
N. Carolina
N. Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
S. Carolina
S. Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
W. Virginia
Wisconsin
Wyoming
Zip:
Phone :
Fax :
Role
in the project (example: Advisor for...; Guest speaker on "topic";
Discussion leader for "book", etc.):
12-A. Resources Used (List resources to be used for program,
i.e., specific book title, documentary, exhibit, etc.)
12-B. Resources Created (List digital or other resources
to be created from the program.)
PROJECT BUDGET.
Quick
Grants and Planning Grants cover honoraria and travel costs for
humanities scholars participating in your project activities.
Both grants cover no more than half the cost of a project. The
Council requires that you calculate the amount of volunteer time,
services, and contributed materials (rental space, phone, postage,
copying, equipment rental, etc.) that your organization expends
for the project. This calculation is called cost-share. The total
cost-share for your project must equal or exceed the total amount
of your request. Estimating such information in your project budget
demonstrates that the sponsor shares the cost of public humanities
programs in Michigan.
Personnel Costs
Quick Grant/Planning
request
(up to $500 for quick grant, $1,000 for planning
grant)
Cost-share estimate
(column total must euqal or exceed grant request)
Total Costs
A.
Project Staff
B.
Planners
C. Program
Personnel (scholar, discussion leader, facilitator,
etc). $500 per event.
Non-personnel
Costs
D. Travel and expenses (current federal rate)
E. Promotion
F. Printing
G. Postage
H. Telephone
I. Supplies/Materials
J. Rental Costs
K.
Other
TOTAL PROJECT COSTS
(required). Certification Regarding Nonprofit
status: By checking this box, the applicant certifies
that the sponsoring organization is not an agency of the federal
government, a for-profit business or an individual.
Organizational
Nonprofit Status Documentation: Provide official documents
(e.g., Articles of Incorporation, IRS determination letters, By-Laws,
Constitutions, etc. which demonstrate that your organization is
either an unincorporated association, a nonprofit or not-for-profit
corporation, a resident tax exempt 501(c)(3/4) organization, or
a tax exempt organization which is a segment of a larger tax exempt
organization) to verify your organization's eligibility.
(required). Certification Regarding the
Nondiscrimination Statutes: By checking this box, the
applicant (other than an individual who submits an application
to Michigan Humanities Council) certifies that it will comply
with the following nondiscrimination statutes and their implementing
regulations:
a.
Title VI of the Civil Rights Act of 1964 (42 USC 2000d et. seq.)
which provides that no person in the United States shall, on
the ground of race, color or national origin, be excluded from
participation in, be denied the benefits of, or be otherwise
subjected to discrimination under any program or activity for
which the applicant received federal financial assistance;
b.
Section 504 of the Rehabilitation Act of 1973, as amended (29
USC 794), which prohibits discrimination on the basis of handicap
in programs and activities receiving federal financial assistance;
c.
Title IX of the Education Amendments of 1972, as amended (20
USC 1681 et. seq.), which prohibits discrimination on the basis
of sex in education programs and activities receiving federal
financial assistance; and
d.
the Age Discrimination Act of 1975, as amended (42 USC 6101
et. seq.) which prohibits discrimination on the basis of age
in programs and activities receiving federal financial assistance,
except that actions which reasonably take age into account as
a factor necessary for the normal operation or achievement of
any statutory objective of the project or activity shall not
violate this statute.
(required). Certification Regarding Debarment,
Suspension, Ineligibility and Voluntary Exclusion -- Lower Tier
Covered Transactions (45 CFR 1169):
a.
The prospective lower tier participant certifies, by checking
this box, that neither it nor its principals is presently debarred,
suspended, proposed for debarment, declared ineligible or voluntarily
excluded from participation in this transaction by any federal
department or agency.
b.
Where the prospective lower tier participant is unable to certify
any of the statements in the certification, such prospective
shall submit to Michigan Humanities Council an explanation of
this proposal.
By
submitting this application, the individual applicant or authorizing
official of the applicant institution is providing the applicable
certifications regarding nonprofit status as well as debarment
and suspenstion and compliance with the nondiscrimination statutes,
as described above.
Please
note that at this time, Michigan Humanities Council is required
to receive a signed copy of the certification with your application.
If you fill out the application on-line, please download the certification
form, sign it, and mail it back to the Council's offices. THE
ORIGINAL, SIGNED CERTIFICATION IS REQUIRED TO BE MAILED TO COUNCIL
OFFICES. You may download the certification form in two formats
by linking below:
Certification
form in Adobe-pdf format .
Certification
form in MS Word format .