NEA National Medal of Arts Nomination Form

National Medal of Arts Nomination Form

To make a nomination, enter the information requested below and click the Submit button. Receipt Deadline: February 27, 2015

Because this is a Web form, it does not have all of the features of a word processing program (i.e., you cannot format your text with bold or italics, and you cannot use the spelling check feature). Use quotation marks or capital letters to set off titles of works or productions. We suggest that you create all text using your preferred word processing program and then copy it into the boxes provided.

Nominee Information

Enter the name of the individual or organization that you would like to nominate:

If individual nominee:
First Name

Last Name

Date of Birth (mm/dd/yyyy)

Place of Birth

If not born in U.S., the nominee is (check one):

US Citizen

Non-US Citizen

Unknown Citizenship

or

If organizational nominee (U.S. organizations only):
Organization Name

Organization's Key Contact/Title

If known, please provide contact information for this individual or organization:
Street Address 1

Street Address 2

City

State

Zip

Telephone Numbers:
Day		Evening
Email

Please select the primary discipline/field of the nominee:

Please complete the following in one page (approx. 400 words):
Tell us why the nominee deserves to be awarded the National Medal of Arts. Summarize key professional credits, accomplishments, or highlights. For Patron/Patron Organizations, outline artistic projects supported. Please identify the source(s) of the information provided.

Nominator Information:

Please provide contact information for yourself.

First Name

Last Name

Organization (if applicable)

Street Address 1

Street Address 2

City

State

Zip

Telephone Numbers:
Day		Evening

Email Address

National Medal of Arts Nominations
National Endowment for the Arts
Office of the Chief of Staff
(202) 682-5434
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