Artwork Outgoing Loan Form PLEASE NOTE: Only ONE PDF file can be attached to each document upload field. Do not upload PDFs with combined documents. Organization InformationOrganization Name*Organization Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Organization Website* Be sure to include http://Organization Purpose*Organization ContactsRegistrar Name* First Last If registrar is not applicable, include logistical contact.Registrar Title*Registrar Email* Registrar Phone*Curator Name* First Last Curator Title*Curator Email* Curator Phone*Marketing/Publicist Name* First Last Marketing/Publicist Title*Marketing/Publicist Email* Marketing/Publicist Phone*Is your Director involved in this exhibition and do they want to be included in related communication?* Yes No Director Name First Last Director Email Director PhoneLoan InformationLoan Purpose* Temporary exhibition Traveling exhibition Education / term loan Loan Start Date* MM slash DD slash YYYY Loan End Date* MM slash DD slash YYYY Requested Commitment Date* MM slash DD slash YYYY Exhibition Title*Exhibition Venue(s)*If the exhibition is traveling, please provide other exhibition venue(s).Works Requested*Exhibition Overview*Loan Overview*PR & Advertising*Publications & Programming*Annual AttendanceEstimated Exhibition AttendanceExhibition Budget*Funding Details*COVID Contingency PlansIs the venue AAM accredited?* Yes No Borrower understands they are responsible for packing, crating and shipping costs.* Yes No Facility ReportAccepted file types: pdf, Max. file size: 50 MB. Please upload your institution’s facility report.Form CriteriaLoan Meets Foundation Criteria* • Advance the Foundation’s mission to challenge and shift perceptions, spark creativity and connect people across cultures. • Share innovative, new research and approaches in one of our art collection areas: • Digital & Electronic Art • Japanese Bamboo • Post-war Painting & Sculpture • Spanish Colonial • Demonstrate professional standards and advance planning: • Request made a minimum of 6 months in advance of the loan start date • Venue(s) meet AAM facility standards • Time on view exceeds 90 days and 1,000 visitors • Preference given to borrowers who request multiple artworks Yes No How did you hear about the Thoma Foundation's artwork loan program?* Thoma Foundation Website Social Media Web Search Colleague/Friend Another Organization Form Completed By* First Last Form Confirmation Email* Keep In touch I’d like to keep up to date with Thoma Foundation activities, exhibitions and news. We will never sell or share your contact information.This field is hidden when viewing the formAccount Record Type IDThis field is hidden when viewing the formCreated by FormThis field is hidden when viewing the formAccount Record Type ID
Artwork Outgoing Loan Form PLEASE NOTE: Only ONE PDF file can be attached to each document upload field. Do not upload PDFs with combined documents. Organization InformationOrganization Name*Organization Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Organization Website* Be sure to include http://Organization Purpose*Organization ContactsRegistrar Name* First Last If registrar is not applicable, include logistical contact.Registrar Title*Registrar Email* Registrar Phone*Curator Name* First Last Curator Title*Curator Email* Curator Phone*Marketing/Publicist Name* First Last Marketing/Publicist Title*Marketing/Publicist Email* Marketing/Publicist Phone*Is your Director involved in this exhibition and do they want to be included in related communication?* Yes No Director Name First Last Director Email Director PhoneLoan InformationLoan Purpose* Temporary exhibition Traveling exhibition Education / term loan Loan Start Date* MM slash DD slash YYYY Loan End Date* MM slash DD slash YYYY Requested Commitment Date* MM slash DD slash YYYY Exhibition Title*Exhibition Venue(s)*If the exhibition is traveling, please provide other exhibition venue(s).Works Requested*Exhibition Overview*Loan Overview*PR & Advertising*Publications & Programming*Annual AttendanceEstimated Exhibition AttendanceExhibition Budget*Funding Details*COVID Contingency PlansIs the venue AAM accredited?* Yes No Borrower understands they are responsible for packing, crating and shipping costs.* Yes No Facility ReportAccepted file types: pdf, Max. file size: 50 MB. Please upload your institution’s facility report.Form CriteriaLoan Meets Foundation Criteria* • Advance the Foundation’s mission to challenge and shift perceptions, spark creativity and connect people across cultures. • Share innovative, new research and approaches in one of our art collection areas: • Digital & Electronic Art • Japanese Bamboo • Post-war Painting & Sculpture • Spanish Colonial • Demonstrate professional standards and advance planning: • Request made a minimum of 6 months in advance of the loan start date • Venue(s) meet AAM facility standards • Time on view exceeds 90 days and 1,000 visitors • Preference given to borrowers who request multiple artworks Yes No How did you hear about the Thoma Foundation's artwork loan program?* Thoma Foundation Website Social Media Web Search Colleague/Friend Another Organization Form Completed By* First Last Form Confirmation Email* Keep In touch I’d like to keep up to date with Thoma Foundation activities, exhibitions and news. We will never sell or share your contact information.This field is hidden when viewing the formAccount Record Type IDThis field is hidden when viewing the formCreated by FormThis field is hidden when viewing the formAccount Record Type ID
