Organization:

Your Name:

Your Title:

Exec. Director:

Address:

City:

State:

ZIP:

Email:

Phone:

Web:

Operating Budget:

# of Staff:

# of Volunteers:

Main Staff Contact:

Title:

Please select the types of arts organizations you prefer to support. Select all that apply:

Website Development/Design
Website Maintenance
Networking/LAN/WAN
E-Commerce
Software Selection
Hardware Selection
Computer Maintenance
Computer Upgrades
Database Design/Development
Database Management
Technology Needs Assessment
Strategic Technology Planning
Integration of Technology in Org.
Software/Hardware Training
Internet Connectivity
Desktop Support
Other Tech Needs: Specify

Provide a brief description of your project and the type of support your organization needs:

I understand that my organization must pay the placement fee ($75 for organizations with operating budgets under $1million and $125 for organizations with budgets $1 million or more) when our project is initiated.