Material Donation Form

Full Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

E-mail

What is the material?

Describe the material. What can you tell us about its history? Who owned or created it? What date ranges are represented?

How much material is it (number of items or boxes)?

In what area or region of the state was most of the material written or produced?

If this is manuscript material, is it an addition to a collection already held by the Society?