Company Organization Details Are you an affiliate or an associate? * Affiliate Associate Organizational Budget (and associated Arts Council Dues) * Annual Budget $0 - $49,999: $125.00 Annual Budget $50,000 - $99,999: $180.00 Annual Budget $100,000 - $299,999: $250.00 Annual Budget $300,000 - $499,999: $300.00 Annual Budget $500,000 - $999,999: $360.00 Annual Budget $1 Million - $1,999,999: $500.00 Annual Budget $2 Million and up: $650.00 Organization Name * Organization D/B/A Name Phone * Email * Street Address * City * State * Select a State/ProvinceAlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHaDaromHaifaHaMerkazHawaiiHaZafonIdahoIllinoisIndianaIowaJerusalemKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTel-AvivTennesseeTexasUnited States Minor Outlying IslandsUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code * Are you a registered 501c3? * Yes No Mission Statement * Descriptions of Arts/Cultural Programming * Current fiscal year end date * Is the organization governed by a Board of Directors? * Yes No NON-PROFIT ELIGIBILITY REQUIREMENTS: Nonprofit organizations located in Westchester County must have an active Board of Trustees and must demonstrate non-profit status with one of the following: 501(c)(3) letter of tax exempt status, Section 501(c)(3) of the Internal Revenue Service Certificate of Incorporation under Section 402 of the New York State Not-for-Profit Law Charter from New York State Board of Regents under 216 of the Education Law Current New York State Bureau of Charities filing receipt Official authorization as an arm of local government (ie, a formal letter on official stationery signed by the appropriate county, city, town or village executive) OPTIONAL: If you know the District number(s) of your governemnt reporesentative, please feel free to include in your application. This information is for advocacy purposes only and will not affect your appliaiton in any way. If you do not know the District(s) and wish to participate, please review to: giswww.westchestergov.com/gismap/ for all your districts Westchester County Districts District 1 District 2 District 3 District 4 District 5 District 6 District 7 District 8 District 9 District 10 District 11 District 12 District 13 District 14 District 15 District 16 District 17 NYS Assembly Member Districts 87th District 88th District 89th District 90th District 91st District 92nd District 93rd District 94th District 95th District 99th District NYS Senator Districts 34th District 35th District 36th District 37th District 38th District 40th District Create an organizational account Username * Password * Confirm Password