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Regional Heritage Stewardship Program: Preservation Needs Assessment

The application requires you to complete a narrative section, provide general information about your institution, and upload several attachments. If you are a department, division, or section of a larger organization (e.g., an archives department in a larger museum, a university archive or library), please answer questions about staff and budget related to your department, division, or section rather than the institution as a whole.

Responses to the Narrative and General Information questions require you to check off all applicable answers to each question and/or can be entered in the appropriate text box. If a required question is not relevant to your organization, enter N/A.

The following Attachments are required at the time of submission:

  • Commitment Letter from Director or Board Chair: The commitment letter should show that the institution as a whole is committed to seeing through a Preservation Needs Assessment. The letter should express support from the board and/or staff to undertake the virtual assessment and to implement recommendations to the best of their ability. In addition, the letter should identify a contact person who will be responsible for coordinating with CCAHA as well as implementing any recommendations that come from the report. Depending on your organization, this letter should be signed by the highest ranking board and/or staff member.
  • Proof of Tax Exempt Status
  • Most Recent Annual Financial Statements: If your most recent financial statements are not available, a copy of Form 990 (Return of Organization Exempt from Income Tax) is also acceptable. Please do not attach bank statements.
  • List of Board Members
  • List of Staff Members and/or Volunteers
  • Written Policy Statements: Attach any written policy statements your institution has in place. These include, but are not limited to: Mission Statement, Collection Management Policy, Collection Development Policy, Exhibition Policy, Loan Policies, Access Policies, Handling Policies, and Emergency Preparedness and Response Procedures. Please be sure to label all attachments accurately.
  • Any Relevant Background Information: This can include brochures, rack cards, newsletters, etc. If you indicate that you have received a survey or assessment previously in Section B.1, include a copy of the executive summary or full report.

Please note that this application form will not save your progress and must be completed in one sitting. Applications must be submitted by Friday, October 16th at 11:59pm MT.

CCAHA is available to assist you in completing the application form. Please contact Anastasia Matijkiw, Program Manager, for assistance or additional information at 215-545-0613 ext. 338 or amatijkiw@ccaha.org.

Click here to learn more about the Regional Heritage Stewardship Program.

This program is funded by the National Endowment for the Humanities.

 

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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
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First Name
Last Name
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First Name
Last Name
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Section I: Application Narrative
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Section II: General
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A. Staff and Collection Use

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Please specify how many full time, part time, volunteer, and student staff members there are in the organization.
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B. Surveys and Policies


If yes, please note the surveyor and date.
Check as many as apply.


C. Collections

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Check as many as apply.

III: Attachments
Please include copies of the following:
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Authorization Signatures:

Name/Title


Note: If the Chair of the Board is not the appropriate title designation, please have the highest ranking official at your organization sign in this location