Foundation Information History of the Foundation Scholarship Information Liberace Scholars Volunteer Membership

Liberace Scholar Application Guidelines

Institution Name:
Institution Type:
Accreditation:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
Web Address:
Do you agree to link your website, and if applicable the “Liberace Scholar’s” website, with the Liberace Foundation website www.liberace.org.
Yes      No
Department Applying:
Department Chair:

Primary Contact for Grant Administration:
Name:
Title:
Phone:
Fax:
E-mail address:

If awarded, information where payment should be sent:
Address:
City:
State:
Zip:

INSTITUTION AND DEPARTMENT PROFILEFINANCIAL INFORMATION

How is the institution supported? (Please provide percentage) State %
Church %
Endowment %
Tuition %
Current Gifts & Grants %
Other (specify below) %
Current Institutional Endowments:
Total Institutional Operating Budget:
Total Department Endowment:
Annual Income from Endowment:
Current Tuition and Fees for Full-time Undergraduate Student:
Current Tuition and Fees for Full-time Graduate Student

DEPARTMENT FACULTY AND STUDENTS
Number of Instructors: Full-time
Part-time
Full-time Departmental Majors Last Year: Undergraduate
Graduate
Departmental Degrees awarded Last Year: Undergraduate
Graduate
Degrees offered by Department: B.A.
B.F.A.
M.A.
M.F.A.
Ph.D.
Other (specify below)

GRANT REQUEST
Amount Requested:
What percentage of the amount granted will be matched?
What will be the source of the Matched Funds?
How many students do you anticipate funding as “Liberace Scholars”?
What selection process will be used to choose each “Liberace Scholar”?
(Check all that apply):		 Student Application
Submission of Portfolio
Audition
Juried Show
Department Nominations
Other (specify below)
When will the selection process occur?
When will the winner(s) be notified?
How and where will you present the award to each “Liberace Scholar”?
(Check all that apply):		 Student Application
Notification Letter
Department Ceremony
Institution Ceremony
Other (specify below)
How and where will you present the award to each “Liberace Scholar”?
(Check all that apply):		 Campus Publication
Local Newspaper
Event Programs
Student’s Home Town Newspaper
Alumni Publication
Institution Catalog
Student Exhibition Programs
Scholarship Publication
Institution Website
Individual’s Website
Other (specify below)

NARRATIVE
Answer each of the following questions and attach your answers to this
application. All answers must be typewritten in a twelve-point font.
Please list the events in which each “Liberace Scholar” will participate:
How are you tracking alumni?
How are/will scholar recipients acquaint themselves with Liberace’s career and legacy?
Describe the Departmental programs, ensembles and facilities.
Describe the policies governing the admission of students to the major.
Provide a brief statement describing the focus of the school, department or program submitting the application. Identify special programs that represent a distinctive strength. Explain the means used to accomplish your mission.
Explain how a Liberace Foundation grant will uniquely benefit your institution and individual students while supporting our mission.

PREVIOUS APPLICANT WORKSHEET
Answer the questions below as appropriate (department refers to the department(s) that applied that particular year).
Year Applied? Funded? Amount? Department?
1977  Y  N  Y  N $
1978  Y  N  Y  N $
1979  Y  N  Y  N $
1980  Y  N  Y  N $
1981  Y  N  Y  N $
1982  Y  N  Y  N $
1983  Y  N  Y  N $
1984  Y  N  Y  N $
1985  Y  N  Y  N $
1986  Y  N  Y  N $
1987  Y  N  Y  N $
1988  Y  N  Y  N $
1989  Y  N  Y  N $
1990  Y  N  Y  N $
1991  Y  N  Y  N $
1992  Y  N  Y  N $
1993  Y  N  Y  N $
1994  Y  N  Y  N $
1995  Y  N  Y  N $
1996  Y  N  Y  N $
1997  Y  N  Y  N $
1998  Y  N  Y  N $
1999  Y  N  Y  N $
2000  Y  N  Y  N $
2001  Y  N  Y  N $
2002  Y  N  Y  N $
2003  Y  N  Y  N $
2004  Y  N  Y  N $
2005  Y  N  Y  N $
2006  Y  N  Y  N $
2007  Y  N  Y  N $