Connecting To Collections Survey
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1. Institutional Information

17%

This survey is a needs assessment tool designed to gather information from North Carolina's cultural heritage institutions for the Connecting to Collections project, administered by the North Carolina Department of Cultural Resources. The survey should take approximately 20 minutes to complete.

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1. Name of institution (Example: Allison-Deaver House):

Name of institution (Example: Allison-Deaver House):

2. Parent institution (Example: Transylvania County Historical Society):

Parent institution (Example: Transylvania County Historical Society):

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3. Mailing address of institution:

Mailing address of institution:

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4. City:

City:

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5. Zip Code:

Zip Code:

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6. County:

County:

7. Street address, if different from above:

Street address, if different from above:

8. City:

City:

9. Zip Code:

Zip Code:

10. Phone number of institution:

Phone number of institution:

11. Web address of institution:

Web address of institution:

12. Email address of institution:

Email address of institution:

13. Person in charge:

Person in charge:

14. Position title of person in charge:

Position title of person in charge:

15. Name and title of contact person if different from person in charge:

Name and title of contact person if different from person in charge:

16. Contact person's phone number:

Contact person's phone number:

17. Contact person's email:

Contact person's email:

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