Washington Trust for Historic Preservation — Valerie Sivinski Fund Application

Instructions

We strongly recommend reviewing the application questions and preparing your answers in a separate document in advance of completing this form. If the page refreshes while you are filling out the form, your work may not be saved.

Applicant Information

Applicant organization:*

Primary contact name:*

First Last

Title:

Email:*

Phone:*

Mailing address:*

Street Address City State ZIP Code

Organizational Documents

Please upload a list of board members and their affiliations as well as your organization's annual operating budget for most recently completed fiscal year.

Drop files here or

Max. file size: 50 MB.

Is the applicant organization a member of the Washington Trust?*

Yes
No
Not sure

The sponsoring organization must be a current member at the organizational level of the Washington Trust for Historic Preservation for this application to be considered. Click here to join or renew.

The sponsoring organization must be a current member at the organizational level of the Washington Trust for Historic Preservation for this application to be considered.

If you are unsure of your organization's membership status, please contact Kristy Conrad by email or by calling 206-624-9449.

Building / Resource Information

Name of historic building / resource:*

Common, historic, or other name(s) of building / resource:

Date(s) of construction:

Architect(s), engineer(s), and/or builder(s):

County

Physical location of building / resource:

Street Address City State ZIP Code

Latitude and longitude or directions:

(if physical address is unclear or not applicable)

Building / Resource Significance

Historic Designation

(mark all that apply)

National Register of Historic Places
Washington Heritage Register
Locally designated through a city or county

Name of local city or county program/register:

(e.g. Tacoma Register of Historic Places, Clark County Heritage Register, Mason County Historic Preservation Register, etc.)

Describe the history of the building/resource, its changes through time, and why it is historically significant.*

Describe the current use and present-day cultural and community significance of the building/resource.*

Estimated number of visitors to the resource annually:*

Has this historic resource ever been listed by the Washington Trust as a Most Endangered Place?

Yes
No

If so, which year(s)?

Project Summary

Please specify the grant amount requested:*

Would your project scope be able to support receiving additional grant dollars if they became available?

Yes
No

Project Type

Preservation or rehabilitation
Design, assessment, or planning
Documentation, research, or historical designation
Advocacy or awareness
Education or interpretation

Brief Project Description*

In one sentence, please summarize the overall project for which you are applying.

Full Project Description

In detail, describe the overall project for which you are seeking grant support. Be sure to include how the Valerie Sivinski Fund grant award specifically will be used.*

How will your project provide community benefit and/or increase public access?*

Does your project explore or support the histories of marginalized or underrepresented communities? If so, please describe.

Letters of Support

Please upload any letters from endorsing organizations or individuals. (Encouraged, but not required.) Letters may be addressed to the Washington Trust Preservation Committee.

Drop files here or

Max. file size: 50 MB.

Project Planning

Project Timeline & Readiness

Please communicate your project timeline and readiness to proceed by breaking your overall project into individual phases/components. Please enter each phase on its own line, list your proposed start and completion dates, and whether or not you are presently ready to proceed with that phase.

Project phase	Proposed start date	Proposed completion date	Ready to proceed?

Use the "plus" button to the right to add more lines for more project phases/components.

If you indicated you were not ready to proceed on any of the project phases, briefly explain why and indicate your plan for becoming ready to begin by your proposed start date.

Project Budget

Please list all planned expenses related to the project and for each expense/item, indicate which phase (from above) it relates to, its estimated cost, its founding source, and whether the funds are currently committed. (The amount requested from the Sivinski Fund should be represented somewhere in the budget.)

Expense/item	Related project phase	Estimated cost	Funding source	Funds committed?

Use the "plus" button to the right to add more lines to the budget table.

Estimated total project cost*

If you indicated funding was not currently committed for any expenses or items (other than those for which you have indicated for Sivinski Funds), briefly explain your plan for securing the funds before your proposed start date.

Planning / Assessment Documents

Please upload any documents used in your project planning and budgeting such as consultant proposals, professional assessments, drawings, contractor bids, etc. that will assist in clarifying the project and its goals, if applicable.

Drop files here or

Max. file size: 50 MB.

Experience

Describe your organization's experience managing other, similar projects to the one you are proposing.

Images

Building/Resource Images*

Upload 6-8 high-resolution images illustrating the entire building/resource, its site, and general physical context.

Drop files here or

Max. file size: 50 MB, Max. files: 10.

Project Detail Images*

Upload 6-8 high-resolution images of the specific project area for which grant funds are being requested.

Drop files here or

Max. file size: 50 MB, Max. files: 10.

Historic Images

Please upload historic images of the building/resource, if available.

Drop files here or

Max. file size: 50 MB.

Image Captions/Credits*

Please upload a text document with thorough image captions/credits to help orient us to the building/resource and the project goals. The information in the document should correspond with the file names of the images uploaded above.

Drop files here or

Max. file size: 50 MB.

Submission

Applications are due October 7, 2024 at 11:59PM PDT. Please click the "Submit Application" button below to complete your application.