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Research Data on Horsehair Art

Business or Museum Name ______________________________________

Contact Name _______________________________________________

Address ___________________________________________________

City, State, Zip ______________________________________________

E-mail _____________________________________________________

Phone Number _______________________________________________

Primary Style of the item:  check one

Item: check one

Approximate Date item was made (circa):__________________________

Approximate Date item was acquired:_____________________________

Did you purchase the item or was it a gift:_________________________

Approximate cost of item at the time it was acquired:_________________

Name of Artist, if known:_____________________________________

Location the item was made (prison/city/state):_____________________

Location the item was acquired (city/state):________________________

Do you have any papers showing authenticity:     yes        no

If you answered yes please send a copy of the papers with this form.

Please send a picture of the item with this form.

List any other information about the item that may be helpful in my research.
Thank you for all your help.