Humanities Program Application

SDHC
Humanities Application

Please note, we are accepting One Book South Dakota, Packaged Reading Programs, Traveling Exhibits and Video Library applications only at this time. Speakers' Bureau programs scheduled prior to November 1, 2006 will not be funded.
Either submit this form electronically or complete and print it out and mail it with your $25 check payable to South Dakota Humanities Council to the address below.

Box 7050
University Station
Brookings, SD 57007

Please complete accurately. Failure to complete all sections may result in denial of your application.

Application Date:
Application Fee Enclosed:
Check:	Speakers Bureau	Packaged Reading
	Film/Exhibit	One Book SD

Sponsoring Organization:

Street Address:

City, State Zip:

Email:

Phone:

Fax:

Non-profit organization: Yes No

Fill in preferred mailing address below:

Coordinator Name:

Work Street Address:

City, State Zip:

Work Email:

Work Phone:

Home Street Address:

City, State Zip:

Home Email:

Home Phone:

Talk Title:

Name of Speaker/Scholar:

Coordinator must contact speaker/scholar regarding availability BEFORE submitting your application.

Program Details

Event 1:
Date:
Time:
Expected Audience:
Site (Building name):
Street Address:
City, State Zip:

Event 2:
Date:
Time:
Expected Audience:
Site (Building name):
Street Address:
City, State Zip:

Event 3:
Date:
Time:
Expected Audience:
Site (Building name):
Street Address:
City, State Zip:

Event 4:
Date:
Time:
Expected Audience:
Site (Building name):
Street Address:
City, State Zip:

Event 5:
Date:
Time:
Expected Audience:
Site (Building name):
Street Address:
City, State Zip:

Event 6:
Date:
Time:
Expected Audience:
Site (Building name):
Street Address:
City, State Zip:

Program Format (Check all that are applicable)

Exhibition
Publication
Project in a Museum
Project in a Library
Discussion (Book, Lecture)
Media (CD-ROM, Web Project)
Media (Radio)
Media (Television)
Conference, Symposia Lecture
Literacy Project
Festival (Film, Fairs, Celebration)
Student Project (Scholar in School)
Preservation/Access
Research (Collegiate Oral History)
K-12 Teacher Institute (Institutes)
Chautauqua, Living History
Speakers Bureau

Media (Film, Video, Slide, Photography)
Local History (Cultural Heritage Tourism, Walking Project)

Target Audience Expected (Check all that are applicable)

Senior Citizens
Native Americans
Literacy
Cultural Tourism
Youth at Risk

By submitting this form, the program coordinator agrees to:

Supervise arrangements, including confirmation of dates with the speaker.

Publicize this program as free and open to the public, when applicable

Acknowledge funding from the South Dakota Humanities Council (an affiliate of the National Endowment of the Humanities) in all publicity

Complete a final evaluation and Cost-share form (mailed out with award letter). Note: The speakers fee and travel costs (state rates) are paid by the Council

Submit a check for $25, payable to South Dakota Humanities Council

Certifies that the sponsoring organization will comply with statutes regarding Nondiscrimination (Civil Rights Act of 1964, Rehabilitation Act of 1973, Title IX of the Education Amendments of 1972, Age Discrimination Act of 1975) Debarment, Suspension, Ineligibility and Voluntary Exclusion; and Americans with Disabilities Act of 19990, and the policies of the South Dakota Humanities Council.

Sponsoring Organization:
Street Address:
City, State Zip:
Email:
Phone:
Fax:
Non-profit organization:	Yes	No

Coordinator Name:
Work Street Address:
City, State Zip:
Work Email:
Work Phone:
Home Street Address:
City, State Zip:
Home Email:
Home Phone:

Exhibition Publication Project in a Museum Project in a Library Discussion (Book, Lecture) Media (CD-ROM, Web Project) Media (Radio) Media (Television)	Conference, Symposia Lecture Literacy Project Festival (Film, Fairs, Celebration) Student Project (Scholar in School) Preservation/Access Research (Collegiate Oral History) K-12 Teacher Institute (Institutes) Chautauqua, Living History Speakers Bureau
Media (Film, Video, Slide, Photography) Local History (Cultural Heritage Tourism, Walking Project)