REQUEST FOR CITY OF AUSTIN ENDORSEMENT 

National Endowment for the Arts (NEA) Our Town

 

Start your request for endorsement from the City of Austin. Review all instructions before beginning. Please contact peggy.ellithorpe@austintexas.gov if you have any questions. 

 
CONTACT INFORMATION
 
What are your preferred pronouns?*
 
 
First Name*
 
 
Last Name*
 
 
What is your job title? *
 
 
What is your email address? *
 
 
What is your phone number? *
 
 
 
 
 
ORGANIZATION PHYSICAL ADDRESS
 
Visit the Austin City Council District map to find your Council District  
What is your Council District? *
 
 
Street 1*
 
 
Street 2
 
 
City*
 
 
State*
 
 
ZIP Code*
 
 
Which Austin-Round Rock Metropolitan Statistical Area (MSA) County are you located? *
 
 
 
 
 
MAILING ADDRESS
 
Street 1
 
 
Street 2
 
 
City
 
 
State
 
 
ZIP Code
 
 
 
 
 
ORGANIZATION DEMOGRAPHICS
 

The following questions help the Economic Development Department assess the diversity of the business or organization. These answers are not related to the outcome of your application. Please list the count of board members and/or leadership of each demographic group. This would include individuals who own, manage, and control the day-to-day operations of the non-profit business.

Each field requires a value ; if you prefer not to answer please enter 0. 

Count of Owners' Control by Race or Ethnicity, enter numbers only:

 
Asian*
 
 
Black or African American*
 
 
Hispanic or Latino*
 
 
Middle Eastern, Arab or North African*
 
 
Native American or Alaska Native*
 
 
Native Hawaiian or Other Pacific Islander*
 
 
Multi Race or Ethnicity (minimum of two different options of the above) *
 
 
White*
 
 
Race or Ethnicity Not Listed*
 
 
Prefer not to answer*
 
 
 
 
 
Count of Control by Gender, enter numbers only. 
 
 
 
Female*
 
 
Male*
 
 
Non-Binary*
 
 
Prefer not to answer gender*
 
 
 
 
 
Count of Control by Other Demographics, enter numbers only. 
 
 
 
Member/s of the LGBTQIA+ community *
 
 
Member/s of the Disability Community*
 
 
 
 
 
APPLICATION INFORMATION
 
1. Organization Name*
 
 
 
 
 
2. Please verify that your organization is a 501(c)3 with a minimum three-year history of programming. *
 
 
 
 
 
3. Please enter your EIN number for 501(c)3 status verification. *
 
 
 
 
 
4. The NEA Our Town grant is for creative placemaking projects only. Does your project integrate arts, culture, or design that will advance local economic, physical, or social outcomes and result in positive systems changes? *
 
 
 
 
 
5. Do you have confirmed partnerships for this project? (If so, mention all partners in your Letter of Intent)*
 
 
 
 
 
6. Are you currently partnering with a City department on this project? (Not required, but if you have an existing City partner, please mention which City department in your Letter of Intent) *
 
 
 
 
 
7. Which of these community areas will your project primarily address? Select key priorities that your project will have the most meaningful impact(s) on. (Be sure to mention these priorities in your Letter of Intent) 
 
 
 
Job Creation/Workforce Development
 
 
 
Equity
 
 
 
Community Cohesion
 
 
 
Social Justice
 
 
 
Agriculture and Food
 
 
 
Economic or Business Development
 
 
 
Education and Youth
 
 
 
Environment and Energy
 
 
 
Health
 
 
 
Housing
 
 
 
Public Safety
 
 
 
Transportation
 
 
 
 
 
 
8. Have you watched this video in advance of making this application for NEA Our Town endorsement? 
FY 2023 Our Town Grant Guidelines and Summative Feedback Session *
 
 
 
 
 
9. To complete the application for endorsement, please download the  Letter of Intent PDF, fill it out, and upload it here. Do not upload more than one complete document.   
 
 
 
File Upload*