CULTURAL AGENCY PROFILE

 

 

This questionnaire is used to gain information about Museums, Historical Societies and similar Cultural Agencies that petition the Board of Regents for a provisional charter to own and hold collection.

INSTRUCTIONS
Please make sure that all questions get answered. If necessary, feel free to add any additional information you may find will be helpful during this review process. Once completed, please send it with supporting documentation to either the mailing or email address above, or with the provisional charter petition to the New York State Education Department Office of Counsel.

I.          GENERAL INFORMATION

  1. Complete Corporate Name of Organization:                                                                       
  1. Address.  (All organizations must have a permanent mailing address.  A Post Office Box is acceptable).

P.O. Box or Street:                                                                                                            

City:                                                                                                                                  

County: ______________________________________________________________

State and Zip Code:                                                                                                           

Telephone number:  (                    )                                                                                    

E-mail address:  _______________________________________________________

  1. Contact Person.  Please supply data for a person to be contacted for further information.  Telephone number should be where he/she can be reached during normal business hours.

Name:                                                                                                                                  

Telephone:   (         )                                                                                                          

E-mail address:  _______________________________________________________

  1. Which of the following categories best describes the organization:
  1. If the organization is primarily a MUSEUM, which of the following best characterizes it?  PLEASE CIRCLE ONLY ONE.
    1. Archeological or Anthropological Museum
    2. Art Museum
    3. Art and History Museum
    4. Art and Science Museum
    5. Children's Museum
    6. General Museum
    7. History Museum
    8. Industrial Museum
    9. Museum Village
    10. Natural History Museum
    11. Science and Technological Museum
    12. Other type of Museum: PLEASE SPECIFY:                                                                            
  1. If the organization is primarily an HISTORICAL SOCIETY or other membership organization, which of the following best characterizes it?  PLEASE CIRCLE ONLY ONE.  
    1. Archeological or Anthropological Organization
    2. Art Association
    3. Genealogical Organization
    4. Historical Society
    5. Preservation Organization or Landmark Society
    6. Other type of membership organization: PLEASE SPECIFY:                                                                           

II.        GOVERNING AUTHORITY

  1. Does the organization have a legally constituted Board of Trustees?           

Yes or No

  1. Please attach copies of the organization's governing documents - that is, the Constitution or By-Laws.  These are required before Incorporation will be granted.

Copies attached?          Yes or No

  1. Please attach a list of the names, and addresses of all officers and members of the Board of Trustees, noting those who have special duties or expertise. 

List attached?               Yes or No

  1. Does the organization formally accept and follow the Code of Ethics for Museums set by the American Alliance of Museums?

Yes or No 

  1. Please attach a list of all committees established by the Board.

List attached?               Yes or No

III.        MEMBERSHIP

  1. Is the organization a membership organization?

Yes or No

If no, does the organization have a subsidiary which acts as a membership group?

Yes or No

           If both of the above questions are No, skip to Section IV.

  1. In the last three years, has membership increased or decreased? 

 

  1. Describe the membership dues structure.

 

 

  1. Does the organization hold regularly scheduled membership meetings?

Yes or No

Are meetings open to the public?

Yes or No

IV.       STAFF AND LEADERSHIP

  1. Does your organization have a paid professional staff?

Yes or No

If yes, please attach a list showing each position, hours per week and salary.  Attach a resume for each professional staff member if your organization’s operating budget exceeds $100,000.

List attached?               Yes or No

Resumes attached?       Yes or No

If yes, is in-service training provided for your organization's staff?

Yes or No

  1. Does your organization use the services of any individual who assists by providing advice?  (e.g., an official of local government, a college faculty member or employee of a service organization).

Yes or No            

  1. Does the organization utilize the services of volunteers?

Yes or No

  1. Does the organization have a program (formal or informal) for training volunteers?

Yes or No 

V.        FINANCES

  1. Is the organization tax exempt under a provision of the Internal Revenue Service (IRS) code?

     Yes or No or Not Yet

  1. If “Yes,” please attach a copy of the organization's IRS tax-exempt letter, if applicable.  (Do not send a copy of your New York State Exempt Organization Certificate)

Copy attached?                        Yes or No

VI.       FACILITIES

  1. Does the organization own and/ or rent real property?

    Yes or No

If no, skip to Section VII

If yes, please describe the land and/or buildings by type (school, church, historic structure or site, etc.).  Give age or date of construction, size, number of rooms, etc. of the structure(s).

 

Is the building or structure listed on the National Register of Historic Places?

Yes or No

           If “Yes,” is it individually listed or listed as part of a district?

 

Is the building or structure accessible to the handicapped (for example, to a person in a wheelchair)?

        Yes or No

  1. How the space is used (meeting room, collection storage, exhibits, office space, etc.). 

 

 

 

  1. Does this space have fire, security and climatic control systems?

Yes or No

 Are fire extinguishers available?

Yes or No

  1. What type of lighting is used in the storage areas?

 

 

What type of lighting is used for exhibits?

 

What provisions have been taken to protect objects on exhibit and/or in storage from ultra-violet radiation present in sunlight and fluorescent lighting?

 

 

  1. Are your facilities open to the public at stated hours without advanced reservations?

Yes or No    

VII.     COLLECTIONS

  1. Does the organization own collections?

Yes or No 

If No, does the organization plan to own a collection in the future?

Yes or No

  1. Using the following definition, attach a description of the organization's procedure used for accessioning objects.

Definition:  Accessioning - the creation of an immediate, brief and permanent record utilizing a control number for an object, assembly or lot, accessed to the permanent collection from the same source at the same time, and for which the institution ahs custody, right and title.  Customarily, an accession record includes the accession number, date and nature of acquisition (gift, excavation, expedition, purchase, requests) course, brief identification and description, condition, provenance, value and name of the staff member recording the accession.

What percentage of the collection is accessioned?  ____________ percent

  1. Using the following definition, attach a description of the organization's procedures for cataloging collections.

Definition:  Cataloging - the creation of a full record in complete descriptive detail of all information about an object, assembly or lot, cross-referenced to other records and files, and often containing a photograph or sketch.  Catalog data are usually in the form of cards or sheets or on computer.

What percentage of the collection is cataloged? ______________ percent

  1. Has the organization deaccessioned any objects from the collections in the last three years?

Yes or No

  1. Please attach a copy of the policies and procedures which govern the care and loan of objects owned by the organization and govern the acquisition and disposal of objects into and out of the organization. If the organizations owns a collection or plans to own a collection in the future this is required before Incorporation will be granted.

 Policies attached?         Yes or No

  1. Are collection record files duplicated and a copy kept elsewhere for security?

Yes or No

  1. Is the organization's collection insured?

Yes or No

  1. Are loaned objects insured?

Yes or No

  1. Are collections regularly surveyed to determine the condition of objects?

Yes or No

  1. Has the organization used the services and/or consultations of outside conservators or restorers?

Yes or No

  1. Does the organization store all of its collections in its own building?

Yes or No

If no, please describe the additional storage (location, owner of facility, type of storage, cost):

 

  1. What type of training do the organization's staff and/or volunteers receive in the proper handling of the collections?  Please describe.

 

 

 

VIII.    EXHIBITS

  1. Does the organization have an exhibit program?

Yes or No

           If no, skip to Section IX.

  1. What amount of space is devoted to exhibits?

 

 

  1.  Does the organization have "period rooms" or other full size displays?

           Yes or No

  1. Does the organization have any permanent displays?

Yes or No

  1. Does the organization have any temporary exhibits?

Yes or No

           If yes, how often are the exhibits changed.

 

 

  1. Does the organization have an exhibits policy?

Yes or No

  1. Does the organization install or maintain exhibits outside your own facilities?

Yes or No

  1. Is there anyone within the organization with a special talent or background for exhibit design and/or installation?

 Yes or No

  1. Does the organization have a written policy concerning the borrowing of exhibit material by long term loan from individuals and other institutions?

Yes or No

IX.       PROGRAMS AND EDUCATIONAL ACTIVITIES

  1. Does the organization offer educational or public programs?

Yes or No

  1. Does the organization respond to research inquiries from the public?

Yes or No

  1. Does the organization have a program for school age (K-12) children related to the school curriculum?

Yes or No

  1. What types of special programs or activities does the organization schedule on a regular basis?

 

X.        PLANS AND FUTURE

  1. What goals does your organization hope to achieve in the next five years?

 

A.

B.

C.

D.

E.

F.

 

  1. What goals does your organization hope to achieve in the next ten years?

A.

B.

C.

D.

E.

F.

 

Please attach the appropriate documents and please be sure to sign and date the back of this form.

Thank you for completing this questionnaire.

Please sign and date the questionnaire when you complete it.

           
Signature of Preparer:                                                                                                              

Title of Preparer:                                                                                                                                  

Date:                                                                                                                                                   

 

 

 

RETURN THIS FORM TO:
Office of Cultural Education
New York State Education Department
C/o Sarah Jastremski
10A33 Cultural Education Center
Albany, NY  12230

Phone: (518) 474-5976
Email: charters@mail.nysed.gov

 

 

Revised October 1, 2013