File:Mary 005.jpg

Form B Window Data

 * Date of form:
 * Name of Building:
 * City:
 * Window location & no. on plan:
 * Window shape:
 * Date of Window:
 * (see Page 3 of instructions for help with the above)
 * Name of artist or studio that created window:
 * City, state:
 * Is name of artist or studio on the window?   YES/NO     If so, how does it appear?
 * Dimensions of window:
 * Height:
 * Width:
 * Type of Glass and Technique: (See Page 4 of instructions. Check as many as apply. Leave blank where unsure)
 * Opalescent Glass:
 * Lead Came:
 * Vitreous Paint:
 * Etching or Sandblasting:
 * Antique or Cathedral Glass:
 * Copper Foil:
 * Silver Stain:
 * Drapery Glass:
 * Enamel Paint:
 * Plating:
 * Jewels or Cast Glass:
 * Slab or Faceted Glass (Dalle de Verre)
 * Subject of Window:
 * (If window is non-pictorial, indicate that on above line)
 * Brief description of subject:
 * List any images that depict ethnic, denominational, local, state, or national leaders or events:
 * List any images that depict social or humanitarian concerns:
 * Inscriptions (Scriptural, memorial, etc.):
 * Is there a Coat of Arms?  YES/NO    If so, what does it represent?
 * Donor of window:
 * Memorial to:
 * Condition of window (List any problems here):
 * Restored by:
 * Restorer's City, state:
 * Date of Restoration:
 * Exterior protection?
 * Type of protection material (Glass, Lexan, etc.):
 * Date exterior protection installed:
 * Archival sources for window information: