Display Request Form

Display Request Form

The Northern New Jersey Chapter of the NAMES Project is very pleased that you will be carrying on the message of the Quilt by hosting a Chapter Quilt Display. We will try to be as helpful to you as possible in the planning and carrying out of your display. Displays should be educationally oriented and may take a variety of forms: display only, display with a speaker, display with a donation vessel, or display with NAMES Project merchandise available for purchase. Small displays may consist of one or two 12 x 12 sections. Small display requests should be received at least 30 days in advance of the event. Large displays, of course, may need months of preparation (depending on the size), and possible approval from the Foundation in Atlanta. All displays of the NAMES Project AIDS Memorial Quilt must be held in an area free from food, beverage and smoking. An honorarium is required for all displays; please see the Fee Schedule below. Non-profit organizations please be aware that non-profit status notification is required on appropriate letterhead.

Areas marked with a

symbol must be filled in before submitting your request.

Please be aware that the Northern NJ Chapter no longer carries merchandize. All NAMES Project merchandize must be purchased from the National Office.

Today's Date:

County of Proposed Display:

Host Contact:

Name of Host Organization:

Daytime Telephone:

Evening Telephone:

Fax:

Your Email Address:

DISPLAY Location:
For example:
NAMES University
Foundation Hall

Street Address of Display Location:

City and Zip of Display Location:

Will this display is open to the public?
(If so it maybe listed in the Upcoming
Displays section of the Chapter's website)

Will this Display be private or only open to your students/staff/membership?

Date(s) of Proposed Display

Times(s) of Proposed Display

Intended Audience for Display:
For example:
      University Students
      At-risk teens
      Predominately Hispanic Audience etc.

Number of 12 X 12 Blocks Requested:

Are there any specific panels you want to request? If so, indicate their number or the name of the person - additional fees may be applicable.

Will there be a table to distribute NAMES Project Information?

Will the Chapter be able to accept donations?

Any questions, comments or additional information you would like to know about

The Honorarium Schedule:
We request an honorarium of $125 from not-for profit organizations and a $200 honorarium from profit organization per block of Quilt. For World AIDS Day Displays an honorarium of $225 for not-for profit organizations and $300 for profit organizations is requested per block of Quilt. This covers transportation and handling expenses related to bringing the Quilt to NJ. Schools (K-12) and not-for profit organizations who do not have the funds can inquire about our grants available to cover some or all of the honorarium. In addition there is a $50 pulling fee for when you request a specific block. Due to policy changes at the National Office the following rush fees will also be in effect. Non World AIDS Day rushes will be charged an additional $100 per block plus a $50 shipping charge. World AIDS Day rushes will be charged an additional $100 per block plus a $50 shipping charge for requests less than 90 days before WAD. World AIDS Day rushes will be charged an additional $150 per block plus a $50 shipping charge for requests less than 60 days before WAD. World AIDS Day rushes will be charged an additional $250 per block plus a $50 shipping charge for requests less than 30 days before WAD.

	Regular Fee *	Regular Shipping	WAD Fee *	WAD Shipping
Not-for-Profits/ Hospitals	$125	NA	$225	NA
Not-for-Profits/ Hospitals Additional Rush Fee	$100	$50	90 days prior = $100 60 days prior = $150 30 days prior = $250	$50
Business/ Corporations	$200	NA	$300	NA
Business/Corporations Additional Rush Fee	$100	$50	90 days prior = $100 60 days prior = $150 30 days prior = $250	$50

* In addition there is a $50 pulling fee for when you request a specific block.