RESEARCH REGISTRATION
FORM
You may fill out this form and bring it with you if are going to use
the LAHS library in person
Your Name ____________________________________ Telephone ________________________________
Address _____________________________________ Facsimile _________________________________
City/State/Zip _________________________________ E-Mail (optional) ___________________________
Identification Used _____________________________________________________
Photo ID (Drivers License) required, attach copy
Extent of research time ___________________________________
SPECIFIC SUBJECT OF YOUR RESEARCH: _________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
MATERIALS TO BE USED:
PURPOSE:
Photo Archives
Article
Book
Books
College Paper
High School Paper
Microfilm
Genealogy
PHD Dissertation
Oral Histories
MA Thesis
Film/Radio/TV
Misc. Records
Other (specify) ____________________________________________
Other (specify) ______________________
I HAVE RECEIVED, READ AND WILL COMPLY WITH ALL OF LEMONT AREA HISTORICAL
SOCIETY RULES, REGULATIONS AND PROCEDURES.
SIGNED _________________________________________________________
FOR OFFICE USE ONLY:
Authorized Signature ________________________________________
Date __________________________________