Donor Questionnaire

(Fine Art: sculpture, paintings, etc.)

Name of Donor: ________________________________ Phone: ____________ Fax:______________

Address:____________________________________________________________________________

Artifact: ______________________________________

Please complete the following questions in as detailed a manner as you possibly can. This information

will help us to document the work and will add to our knowledge concerning the materials

held in the Illinois State Museum collections.

1. Who created this object and when was it made?

2. How did the object come enter your possession? Was it a gift or a purchase?

3. Has this object ever been exhibited? Where? When?

4. Do you have any photographs relating to the object?

5. Do you have any documents (receipts, articles, etc.) relating to the object?

6. Is there any additional information about the object or the maker that yo think might be useful for our

records?