Form LMMG Form 1 LMMG Form 1 LMMG Registration Form

Signup for Let’s Move! Museums and Gardens

 

Institutional Information

Your name

Your title

Name of institution

Address line 1

Address line 2

City

State

Zip

Phone number

E-mail address

Institution’s main Web site address

 

Please note: Only your institution’s name, address, and web address will be posted on the IMLS website.  You personal contact information will not be posted.

All institutions must select at least one of the first two priorities.

Priority #1: Eat healthy, get active exhibits
Click here for examples of exhibits.

	We will do this.	We currently do this.	Not applicable to our institution.
Offer interactive experiences or exhibits that provide messages about healthy choices to visitors and to track our number of visitors.

 

If you have responded "We currently do this,” please tell us a bit more about your exhibit(s):

Priority #2: Learning about healthy food choices and physical activity through afterschool, summer and other programs
Click here for examples of programs.

	We will do this.	We currently do this.	Not applicable to our institution.
Offer afterschool, summer and other programs that include messages about healthy choices and to track our number of participants in such programs.

 

If you have responded "We currently do this,” please tell us a bit more about your program(s):

 

Institutions that serve food should also select at least one of the second two priorities.

Priority #3: Healthy food service
Click here for healthy food service examples and guidance on how to define “healthy food.”

	We will do this.	We currently do this.	Not applicable to our institution.
Offer healthy food options in my food service operation.

If you have responded "We currently do this,” please tell us a bit more about your healthy food options(s):

Priority #4: Learning about healthy food choices and physical activity using food service operation.
Click here for learning examples.

	We will do this.	We currently do this.	Not applicable to our Institution.
Provide interpretation about healthy food choices and physical activity in my food service operation.

 

If you have responded "We currently do this,” please tell us a bit more about your interpretation(s):

Submit

[Note: After hitting submit, users receive the following message]

Thank you for your interest in signing up as a

Let’s Move! Museum &Gardens participant.

Joining Let's Move! Museums & Gardens is an opportunity to demonstrate your institution's commitment to your community and to engage in a high visibility national initiative that has the capacity to change children's lives.

The information you have submitted is currently being reviewed by IMLS staff. Once this review is complete, we will post your institution's information on the IMLS website. We will contact you if there is any problem with your submission.

Please note: Institutions that sign up to become a participant in Let’s Move! Museums & Gardens will receive communications from IMLS and outside partners about this initiative only. Your information will not be added to any additional distribution lists.

------------------------------------------------------------------------------

This information collection is being conducted in conformance with the Museum and Library Services Act of 2010, as amended. IMLS intends to make institutional participation information publicly available. However, information specifically identifying any individual will be protected from public disclosure to the extent permitted by law.

The OMB control number, ####-###, expires on MM/DD/YYYY. The Institute of Museum and Library Services may not conduct or sponsor, and a person is not required to respond to, an information collection unless it displays a currently valid OMB control number.