Form Application form 6 Application form 6 National Award for Library and Museum Services Nominatio

2007 Nomination - Cover Sheet
National Awards for Museum and Library Service

1. Institution Name
2. Institution’s Mailing Address
City
3. Phone Number

State

Zip

4. Fax Number

5. Web Address
6. Name of Institution’s Director/CEO
Title

Phone Number

E-mail Address
7. Type of Organization (check one in the appropriate category)
Museums:








Aquarium
Arboretum/botanical garden
Art museum
Children’s/youth museum
General museum
Historic house/site
History museum









Nature center
Natural history museum
Planetarium
Science/technology museum
Specialized
Zoo
Other (specify)






Research
School
Special
Other (specify)

Libraries:





Archive
College/university
Consortium
Public

8. Institution’s Annual Budget

9. Number of Full-time Staff

10. Community Population

11. Number of Days Open/Year

Part-time Staff

12. Number of People Served Through Community Programming
13. Name of Nominating Individual
Title

Relationship to Institution

Phone Number

E-mail Address


2007 Nomination - Attachments
National Awards for Museum and Library Service
B. Statement of Purpose/Mission Statement & Brief Institutional History
Provide the institution’s mission statement or statement of purpose as well as a brief institutional history (not to
exceed one single-spaced page; no less than 12-point type).

C. Narrative
The nomination should address the following questions thoroughly and succinctly (not to exceed five single-space
pages; no less than 12-point type). The jurors determining the pool of potential award winners will focus closely on
your answers to these questions.
1. What are the institution’s goals for community service? How do these goals reflect the institution’s mission and
strategic plan? How do they reflect an assessment of the broader community’s learning or informational needs?
2. Describe the population groups/communities the institution is reaching through its community services and
provide examples of the programs and services that have been developed for these communities. How are the programs and services evaluated to determine whether they are successfully meeting the needs of the audiences?
3. How does the institution work with other organizations within the broader community to provide programs and
services and to play a leadership role?
4. How does the institution demonstrate sustained commitment to the community?

D. Institutional Financial Statements
Include a copy of your institution’s financial statements for the past two complete fiscal years. If at time of nomination your fiscal year is complete but not yet audited, please submit these unaudited figures and label as such.
If your institution is part of a larger organization (municipal government, university, etc.) do not include financial
statements for the parent organization, only for the nominee.

E. Letters of Support
An institution may submit up to three letters of support with the nomination. These letters should come from community members who have direct knowledge of the institution’s community service. It is recommended that the
letters come from different segments of the broader community served by the institution.



National Award for Library Service/National Award for Museum Service
Nomination form instructions

Nomination Information
An institution may be nominated by one of its own employees or by a member of the community with a special interest in
the institution. If you are an employee of the museum or library you are nominating, please state your title. If you are a
member of the community, please indicate your particular interest in the institution.
Your application must include all five parts:
A. Cover Sheet (page one of the Nomination Form)
B. Statement of Purpose/Mission Statement & Brief Institutional History
Provide the institution’s mission statement or statement of purpose as well as a brief institutional history (not to exceed
one single-spaced page; no less than 12-point type).
C. Narrative
The nomination should address the following questions thoroughly and succinctly (not to exceed five single-space pages;
no less than 12-point type). The jurors determining the pool of potential award winners will focus closely on your answers
to these questions.
1. What are the institution’s goals for community service? How do these goals reflect the institution’s mission and
strategic plan? How do they reflect an assessment of the broader community’s learning or informational needs?
2. Describe the population groups/communities the institution is reaching through its community services and
provide examples of the programs and services that have been developed for these communities. How are the
programs and services evaluated to determine whether they are successfully meeting the needs of the audiences?
3. How does the institution work with other organizations within the broader community to provide programs and
services and to play a leadership role?
4. How does the institution demonstrate sustained commitment to the community?
D. Institutional Financial Statements
Include a copy of your institution’s financial statements for the past two complete fiscal years. If at time of nomination
your fiscal year is complete but not yet audited, please submit these unaudited figures and label as such.
If your institution is part of a larger organization (municipal government, university, etc.) do not include financial
statements for the parent organization, only for the nominee.
E. Letters of Support
An institution may submit up to three letters of support with the nomination. These letters should come from community
members who have direct knowledge of the institution’s community service. It is recommended that the letters come from
different segments of the broader community served by the institution.
Nominations must be postmarked by February 15, 2007 to this address (no faxes please):
The National Award for Museum and Library Service
Office of the Director
Institute of Museum and Library Services
1800 M St. NW 9th Floor
Washington, DC 20036-5802
OMB Clearance: 3137-XXXX Expiration date: XXXXXXXXX