Hearing Aid Profession Museum Donation Form

Hearing Aid Profession Museum Donation Form

Thank you for considering donating artifacts to our museum. Please fill out the form below with the details of the items you wish to donate.
Please be sure to fill out all required fields marked by an (*)
Donor Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
How many items are being donated?
List items being donated with the year (if known)
How do these items represent the development of the profession?
Please upload an image of each item.

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In order to avoid duplications, the acceptance of items will be decided by the curators.
Do you wish to permanently donate item(s) to the IHS Museum? *
Should be Empty: