543 Hanley Industrial Ct., Ste. 201 . St. Louis, MO 63144-1905 . 314.781.9660 . 1.800.357.0909 FAX 314.781.9681 . EMAIL mail@mohumanities.org . WEB www.mohumanities.org Museum on Main Street Smithsonian Exhibit The Way We Worked – 2011 – 2012 Application - Request Form to host The Way We Worked Exhibit Application – Request Form does not guarantee site selection. All narratives should be two (2) pages in length. Applications are to be submitted to the Missouri Humanities Council by October 15, 2010 (postmarked or emailed). Tours for the exhibit begin in the fall of 2011. Note: The Way We Worked exhibit is expressly designed to reach rural cultural organizations and the audiences they serve with population of 20,000 and under. There are space requirements for optimal viewing. The exhibit is comprised of five (5) free standing kiosks requiting 700 square feet of floor space and 8 foot ceiling minimum. 1) Organization Information Host Institution: Co-host (if applicable): Address City: Zip Code: Physical Address (if different than above): City: Zip Code: County: Name of Primary Contact: Telephone #: Alternative #: Fax #: Email: Alternative Email: Website: Days & hours of operation: Annual visitorship: Population: (include municipality and county) Region: (include surrounding municipalities and counties) Nearest large town/city: Annual operating budget: (include documentation) Source of Revenue: (government funding, grants, donations, fees, individuals, etc.) 501(c)3 tax exempt status: Incorporated (include documentation): Size and composition of board (include comprehensive listing): Is your board of directors active in the community and capable of inspiring others to join in projects? Give examples of success. (Attach additional pages as needed.) Size and composition of staff: (include staff listing with titles) Who will be coordinating the exhibition? Number of regular volunteers: TWWW APPLICATION Can your institution accommodate an 8 foot high, 700 square foot exhibition? Location of exhibit display if not on institution site: Name & Contact Information of Site Coordinator: Brief profile of your institution (include brochures, promotional materials) 2) How will hosting The Way We Worked exhibit help your institution? (Attach additional pages as needed.) 3) Community involvement is central to the success of the exhibition. Which community leaders and other community organizations will you involve in the planning of the exhibition? Have you asked them to commit to the project? (Include listing of leaders and organizations.) 4) Have you reviewed information about The Way We Worked at www.museumonmainstreet.org? 5) In what capacity is your institution able assist in shipping the exhibition from one site to another? 6) Two people from your organization must be able to attend both an Orientation & Program Planning Workshop and an Installation Workshop (dates and locations to be announced)? Applications for The Way We Worked should be submitted to the Missouri Humanities Council by October 15, 2010 (postmarked or emailed). Tours for the exhibit begin in the fall of 2011 through 2012. Note: This application is available online at www.mohumanities.org. If you do not have internet and email access, please contact the Missouri Humanities Council office at 1.800.357.0909 or email: mail@mohumanities.org to make other arrangements for submission of materials. For more information on Museum on Main Street – Smithsonian Exhibit visit www.museumonmainstreet.org or www.si.edu. TWWW APPLICATION