Museum Submission Form

Complete any information you have below.

If you do not know the answer to any question below please leave it blank.

Estimated Age? (Date) 

Country of Origin? 

Manufacturer? 

Catalog Number? 

What Material is it made of?  (i.e. gold, sterling silver, brass, nickel over brass, chrome, celluloid, wood, papier-mâché, ivory, etc.)

List any Markings?  (i.e. Hallmarks, .925, sterling, mfg mark, etc.)

Is there a Patent or Design Number on it?  

Is there a Patent or Design Date on it?  

What size is it?  Inches Centimeters (height x width): 

Description and Comments:  (Describe it in your own words.)

Is there anything on the reverse?:  (same as front; any engravings)

Submitted by:  (This info will be visible to the general public in our acknowledgement to you.  Do not list your name, e-mail address or other information if you wish to remain anonymous.)

Comments for Museum Curator:  (This info will not be visible to the general public.)

Note: A good digital picture or laser scan in jpeg format should be attached in a separate e-mail to webmaster@matchsafe.org

Tell us how to get in touch with you: