| Name |
|
| Address |
|
| Phone |
|
| Fax |
|
| E-mail |
|
| The records in my possession, or to which I have access, concern the following: (Note: please feel free to check both if appropriate) |
My personal/professional life and/or family history
My organization/group*
(*Note: If applicable, please include the name and address of your organization/group below.)
Name of Organization/Group:
Address:
Phone:
Fax:
E-mail:
|
| Types of records in my possession, or to which I have access (check all that apply): |
Artwork/Sketches
Drawings/Illustrations
Posters/Graphics
Audio Tapes
Flyers/Programs
Publications
Awards
Financial Records
Reports
Bound Volumes
Minutes
Scrapbooks
Charters/By-laws
News clippings
Video Tapes
Correspondence (business)
Newsletters
Other
Correspondence (personal)
Photographs |
| What dates do the materials cover? |
1950s or earlier
1960s
1970s
1980s
1990s or later |
| Where are the records currently stored? |
|
| What condition are the records in? |
Good Fair Poor |
| Quantity of records – # of: |
folders or boxes or file cabinet drawers |
| Are these records in English? |
Yes No ... If not, what language? |
| Do you have materials that document the founding/establishment of your organization or group? |
Yes No |
| Do you have materials about organization policies and how they came about? |
Yes No |
| Do you or other members have subject files about your organization or group's activities? |
Yes No |
| Would you or your organization/group consider donating records to a library, archival repository, or historical institution? |
Yes No |
| Would you like more information about how to store records in a historical repository? |
Yes No |
| Are there any other individuals that might have additional relevant information? |
Name:
Address
Phone:
E-mail:
|
| Please feel free to attach/include any additional biographical information or information regarding your organization/group. |
|
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