(Proposed Questions) Use separate sheets of paper to list this information (either in English or Polish). Please type. Number the replies according to the pattern given below. It is only necessary to give as much information as you want to give (aside from the basic information in items 1, 2, and 3)

Clean typed or laser printed submissions make our job easier. For electronic format submissions please see "How to Submit" Thank you!

1. Names (full name, including middle name; maiden (family) name if applicable; aliases or pseudonyms used

2. Address - for contact purposes only (number, street, city, town, zip, telephone, fax, e-mail) Will NOT appear in public Data Base or printed publication

3. Personal information - sex (m/f), date and place of birth, citizenship, year of arrival in US if born elsewhere; parents' names, incl. mother's maiden name; marital status, spouse's first name (and family name if applicable), children's names and ages

4. Schools attended and dates (years), degrees, scholarships, academic awards received

5. Profession(s), positions held and dates (years), professional achievements and awards

6. Clubs and Organizations - membership in clubs past and present (years), positions held, achievements and awards received

7. Political Activities - party affiliation, elected or appointed offices held, accomplishments and awards received (years)

8. Military record - ranks achieved (years), country and branch in which served, places stationed, decorations, awards, accomplishments

10. Religious affiliation - positions held in your church

11. Publications, books, articles, etc. (list with years of publications)

12. Other significant accomplishments, projects, awards, travels, etc. things and events that have substantially affected your life

13. Photograph - portrait or photo with wife and children, receiving award, etc. photograph WILL be returned to you after scanning.

14. For our files - a copy of a printed article about yourself that appeared in any print media, for example: a "Who's Who," professional listings, in newspaper or magazine, event program, newsletter or book

NOTE: If this questionnaire is being completed for a person who is already deceased please provide the place and date of death in the personal information. Also please provide your name and address under items 2 and 3, stating that you are filling this out for a person who is now a historical figure.