Fitchburg Historical Society

RESEARCH REQUEST FORM

Please print this form and fill it out describing what you’re researching. Then mail it to the Fitchburg Historical Society,
50 Grove St., P.O. Box 953, Fitchburg, MA 01420. The more information you provide us, the easier the search will be.
If you are requesting information about machinery or tools, a picture or photograph would be helpful.

Date _______________

Name _________________________________________

Address _______________________________________

City ______________________ State _________ Zip ________________

Tel. ________________________ Fax ___________________________

Email ________________________________________________________

I, _______________________, have read the Fitchburg Historical Society Research
p;            (Name)

Policy and I agree to pay the fees as outlined up to a limit of ____ hours or $ ________.

_______________________________________
sp;           (Signature)

Key topics you’re researching _____________________________________

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Details of research questions______________________________________

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