Oral History Contact Information Form

Please print this form, complete each line clearly, and mail it to:

Mooresville Museum Oral History Program

272 Heritage Pl, Mooresville, NC 28115

Your Name:

_____________________________________________________________________________________________

Address:

_____________________________________________________________________________________________

Phone #:

(          )  __________  -  ___________________

    Email: ______________________________________________
   

Are you interested in receiving more information about this program?

Yes No

Are you interested in being interviewed for an Oral History?

Yes No

Would you like to suggest someone to have their Oral History taken?

Yes No  If yes, who?  ______________________

Are you a Mooresville Museum member?

Yes No I would like to be

What is your relationship to Mooresville? (Use back or attach paper if you need more room)

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

Thank you for your interest!

Internet Form
Revised 26 Feb 2006