Application Form for Endorsement of Event or Activity Iowa Abraham Lincoln Bicentennial Commission

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1. Enter your project title in the space provided below.

   
   

2. Please provide the following contact information:

   Name
   Organization
   Street Address
   Address (cont.)
   City
   State/Province
   Zip/Postal Code
   Work Phone
   E-mail
   Website

    

3. Type of applicant:  Non-profit organization Governmental/Municipal organization Educational organization Other:
   

4. If "other" - please specify: 
   

5. Tell us when your date begins:  -- mm/dd/yy
    

6. If applicable, please tell us when your activity ends: -- mm/dd/yy
   

7. Please describe / list your target audience

   
   

8. How many attendees are you anticipating?  
   

9. Please check all IALBC goals satisfied by this event or activity:

   Increasing knowledge and awareness of Lincoln in the US and Iowa
   Encouraging public participation and attendance at Lincoln bicentennial activities
   Increasing historical literacy about Lincoln for young people
   Encouraging research, scholarship, and increased understanding of Lincoln
   Leveraging the Lincoln bicentennial for discussion of themes of freedom, democracy and equal opportunity; serving as a catalyst for conversation and engagement of diverse perspectives
   Creating a lasting legacy of Lincoln themes and contributions to endure beyond the bicentennial
   

10. With this signature, I affirm that the proposed event or activity will be fully accessible and open to the public, and if endorsed will comply with the Responsibilities and Expectations of Endorsed Projects detailed in the Guidelines.

    Electronic Signature

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Iowa Abraham Lincoln Bicentennial Commission.
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Revised: 05/14/08