MICHIGAN STAINED GLASS CENSUS

Preliminary Survey Form


Personal Background

*Name: required
*E-mail Address: required
Organization (if applicable):
Address:
City: State: Zip:
Area Code: Phone:

 

LOCATION OF STAINED GLASS WINDOWS IN YOUR AREA OF MICHIGAN (or elsewhere in Michigan):

1

Name of the building:
Building Address:
City: State: Zip:
Telephone: Area Code: Phone:
Contact Person:

2

Name of the building:
Building Address:
City: State: Zip:
Telephone: Area Code: Phone:
Contact Person:

3

Name of the building:
Building Address:
City: State: Zip:
Telephone: Area Code: Phone:
Contact Person:

4

Name of the building:
Building Address:
City: State: Zip:
Telephone: Area Code: Phone:
Contact Person:

Comments

If you have difficulty returning the survey form on line, please print the form and type or print in black ink.

Return your completed PRELIMINARY SURVEY FORM to:

Michigan Stained Glass Census
Michigan State University Museum
East Lansing, MI 48824-1045

If you would like to participate in the Michigan Stained Glass Census as a VOLUNTEER CENSUS TAKER, by visiting buildings where stained glass windows are located and recording information about the windows, please contact us and we will send you a set of Census forms and instructions on how to do this important research.

Thank you for helping to discover, document and preserve Michigan's stained glass heritage!

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MICHIGAN STAINED GLASS CENSUS
Please send questions or comments to: stainedglass@museum.msu.edu



The Michigan Stained Glass Census is supported in part by the Michigan Council for Arts and Cultural Affairs