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Historical Marker Application
1. Application Date: __________________
2. Subject of Proposed Marker: _____________
3. Marker Size: (see prices below) approximately 100 words _____ approximately 250 words _____
4. In 1,000 words or less, give the statewide and/or national significance of the subject and attach it to this application.
5. Documentation: List and attach photo copies of at least two sources for each of the facts stated in item 4 that are not common knowledge. At least one source should be primary or original.
6. Give the exact location for installation of proposed marker, including route or street address and attach proof of permission to erect the marker on the proposed site. ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________
7. Please attach a $500 administrative fee. This fee is part of the overall marker cost and is nonrefundable. It is strongly recommended that you contact the office to determine if your proposed subject is eligible prior to submitting the application and fee.
8. Sponsoring Organization: __________________________
Contact Name: _________________________________
Address: _________________________________
_________________________________
Phone: ______________ Fax: _______________
County: _______________ E-Mail: _____________
9. Other persons or co-sponsors: ________________________
__________________________________________________
Agreement:
The Illinois State Historical Society will oversee the casting of the marker (of aluminum) in conformance with ISHS design and format. It will contain the name of the sponsoring organization as well as the name of the Illinois State Historical Society and the year in which it was cast in addition to the text. It is the responsibility of the sponsoring organization to erect and mount the marker at the location established in agreement with the Society. The marker will be maintained by the sponsoring organization.
Payment for the marker is due when the text is approved and ready for casting. The Society will notify the sponsoring organization at that time.
It is agreed that the sum of
_______ $2,000.00 per small marker (29" x 40.5") (includes administrative fee)
_______ $3,000.00 per larger marker (44" x 51") (includes administrative fee)
will be paid to the Illinois State Historical Society upon notification that text and location are approved. These prices do not include shipping charges.
For Sponsoring Organization: For ISHS:
________________________ _________________ Sponsoring Organization Authorized Signature
________________________ __________________ Title Title
------------------------------------------------------------------------------------- For office use only: Form received: __________ Approvals: Documentation (approved and dated): _______/__/__ Text (approved and dated): ___________/__/____ Date payment received: _____/___/____ Date to foundry: ____/__/____ Mold (approved and date): ____________/__/___ Date marker erected: ___/___/____
ISHS - Search Historical Markers Database
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