GEOGRAPHIC LOCATION OF PROJECT
ACTIVITY![](media/image1.jpeg){width="0.7708333333333334in"
height="1.292361111111111in"}

**Instructions:** To assist the Arts Endowment in reporting to Congress
on the geographic location of Endowment-supported activities, complete
and return [one]{.underline} copy of this form (via mail or fax) to the
address below within 30 days of receiving your award letter or with your
first payment request, **whichever comes first.** [No award funds will
be released]{.underline} until this information is received.

Grants & Contracts Office/Geographic Location Project FAX:
202-682-5609/5610

National Endowment for the Arts

1100 Pennsylvania Ave., NW, Room 618, Washington, DC, 20506

+------------+--------------------------+-----------+-----------------+
| Cooperator | > **     **              | DCA \#    | [.              |
| Name:      |                          |           |                 |
|            |                          |           |   ]{.underline} |
+------------+--------------------------+-----------+-----------------+
| Address:   | **     **                | Award     | \$ **     **    |
|            |                          | Amount:   |                 |
+------------+--------------------------+-----------+-----------------+
|            | **     **                |           |                 |
+------------+--------------------------+-----------+-----------------+

**Note**: In responding to the following, provide information about
places where award-supported activities will occur during the period of
support (including areas reached through touring, broadcast, etc.),
[not]{.underline} places from which audiences may be drawn. **If you
have questions about this form, please call 202/682-5424**.

**A.** Check the **one** item that best describes where project activity
for this agreement will take place:

In one city/county.

In more than one city/county but within one State (include State-wide
activity).

In more than one State but within the same metropolitan area (e.g., New
York City/New Jersey).

In more than one State/metro area, but within the same geographic region
(e.g., Western States).

In more than one State and more than one geographic region (include
nationwide activity).

Outside the United States and its jurisdictions.

**B.** Based on current knowledge, list locations where project activity
for this award will take place, including the [complete]{.underline}
address (street/city/state/Zip+4) for each venue. Note that the full
Zip+4 [must]{.underline} be provided; for assistance with Zip Codes, go
to <http://zip4.usps.com/zip4/welcome.jsp>. Follow the sample format
(provided on the next page) or attach any similar listing of project
activities and their locations.

**COOPERATOR RESPONSE:**

Attach separate sheet(s) as necessary, indicating cooperator name and
DCA number at the top of each page.

Activity Title and/or Type Activity Date(s) Location(s) \[Name &
address; Zip+4 required.\]

  ------------------------ ------------- --------------------------------
  **     **                **     **     **     **

  ------------------------ ------------- --------------------------------

**C.** Contact Person for further geographic location information
(please print or type):

  -------- -------------------------------- ------------ ----------------------
  Name:                                     Telephone:   **(   )     -     **
                                                         ext. **     **

  Title:                                    E-mail:           
  -------- -------------------------------- ------------ ----------------------

Geographic Location of Project Activity

**SAMPLE FORMAT**

+----+----------------------+------------+-----------------------------+
|    | **[Activity Title    | *          | **                          |
|    | and/or               | *[Activity | [Location(s)]{.underline}** |
|    | Type]{.underline}**  | Da         |                             |
|    |                      | te(s)]{.un | ***[\[Name & Address;       |
|    |                      | derline}** | Include                     |
|    |                      |            | Zip+4\]]{.underline}***     |
+----+----------------------+------------+-----------------------------+
| E  | Performance by Lone  | 9/1/08     | Paramount Theatre           |
| x. | Star Dance           |            |                             |
| 1  | [Paramount           |            | 713 Congress Ave.           |
|    | Theatre]{.mark}      |            |                             |
|    |                      |            | Austin, TX 78701-3216       |
|    | Company (full        |            |                             |
|    | company)             |            |                             |
+----+----------------------+------------+-----------------------------+
|    | In-school            | 10/08      | Audie Murphy Middle School  |
|    | lecture/demo by      |            |                             |
|    | choreographer J.     |            | 53393 Sun Dance Dr.         |
|    | Smith and Lone Star  |            |                             |
|    | Dance Company        |            | Ft. Hood, TX 76544-4001     |
|    | (touring ensemble)   |            |                             |
|    |                      |            | Additional school (TBA)     |
|    |                      |            |                             |
|    |                      |            | Ft. Hood, TX                |
+----+----------------------+------------+-----------------------------+
|    |                      |            |                             |
+----+----------------------+------------+-----------------------------+
| E  | [Art                 | Sept.-     | San Francisco State         |
| x. | Today]{.underline}   | Dec. '08   | University Art Museum       |
| 2  | traveling exhibition |            |                             |
|    |                      |            | 1600 Holloway Ave.          |
|    |                      |            |                             |
|    |                      |            | San Francisco, CA           |
|    |                      |            | 94132-1722                  |
+----+----------------------+------------+-----------------------------+
|    |                      |            |                             |
+----+----------------------+------------+-----------------------------+
|    |                      | March --   | Seattle Art Museum          |
|    |                      | July '09   |                             |
|    |                      |            | 1300 First Ave.             |
|    |                      |            |                             |
|    |                      |            | Seattle, WA 98101-2003      |
+----+----------------------+------------+-----------------------------+
|    |                      |            |                             |
+----+----------------------+------------+-----------------------------+
| E  | [New                 | 2009       | WNYC (New York, NY)         |
| x. | Jazz]{.underline}    |            |                             |
| 3  | radio broadcasts     |            | WWUH (West Hartford, CT)    |
|    |                      |            |                             |
|    |                      |            | WVPS (Burlington, VT)       |
|    |                      |            |                             |
|    |                      |            | (Alternatively, attach a    |
|    |                      |            | station carriage list.)     |
+----+----------------------+------------+-----------------------------+