Printable Form

Sycamore Historical Society Museum

Research Request Form

Name:________________________________________________________________

Address: ______________________________________________________________

Telephone:__________________

Reason for Research: ____________________________________________________

Research Topic (Be as specific as possible)  __________________________________

Office Use

Staff Initial: ______      Date Received: _____     Date Completed:_____
Staff Time: ______        Visitor Time:  ______

Request:  Walk-in _____     Appointment _____     Phone _____      E-Mail _____
                  Mail ________      Other: _______________________

Other Sources Recommended: ____________________________________________

Copy charges: _________                         Photo charges: _________________

Notes:  ____________________________________________________________
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