| Time Capsule
Questionnaire: Please provide
your information below:
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Name of Time Capsule
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1. Organization |
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Full Name of Organization
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Street Address
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City
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State
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Zip
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Country
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Telephone
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Telex
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2. Relevant
Representative |
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Title
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First Name
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Last Name
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Street Address
(if different from that of the Organization)
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City
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State
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Zip
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Country
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Telephone
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Telex
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FAX
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3. Purpose of
Time Capsule |
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Please indicate
which of the following applies (you may choose more than
one) |
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Commemoration
(please state the event commemorated) |
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Promotion,
Publicity, or Public Relations in the present (please give
details, sources and dates) |
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Contribution to the
Future (please state why this was thought necessary or
desirable; for example, existing museums, libraries, etc.
might be thought inadequate to give our descendants a true
picture of the present) |
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Self-expression by
originator of the time capsule idea or by others involved in
the project (please provide details) |
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Other factors not
mentioned above |
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When would you
like the capsule to be found and by whom?
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4. The Capsule |
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What was used as
the container?
For example: Material, Dimensions, How was it sealed?
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What specific
steps (if any) were taken to ensure its survival?
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What specific
steps (if any) were taken to ensure its discovery?
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Origin or name
of manufacturer of container
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Street Address
of the Manufacturer
(if different from that of the Organization)
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City
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State
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Zip
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Country
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Telephone
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Telex
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FAX
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Does
the container bear on its outer surface a message or
instructions to the future finder?
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5. Place of
Deposition |
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Individual or
Organization address where capsule was deposited:
Name
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Street Address
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City
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State
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Zip
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Country
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Telephone
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Telex
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FAX
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Precise position
of capsule in or near a building or other point of
reference.
PLEASE COMPLETE THIS SECTION CAREFULLY. If you do not
wish to reveal the location of the capsule, please give the
name and full address of the bank or other place where such
details are kept. REMEMBER: WHAT YOU RECORD HERE MAY
BE THE ONLY AVAILABLE CLUE TO YOUR TIME CAPSULE FOR FUTURE
FINDERS.
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Is the
deposition location marked in some way (e.g., by means of a
plaque unveiled at the time of deposit?)
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List the website
or URL where photo(s) of the time capsule will be available,
if any. Also list any URLs of newspaper articles
relating to the time capsule.
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6. Contents |
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Please list below EVERYTHING (from the important to the
trivial (including both official and unofficial items) that
was included in the time capsule.
If you do not know or recall everything, list as much as
possible. Indicate, if you wish, those items regarded as especially
significant by you or your organization (please specify
which). Please also indicate if anything secret or
otherwise undisclosed was included in the capsule, and
included details if appropriate.
Please provide full names and dates of newspapers or
other published items included in the capsule; dates and
denominations or coins; technical and content details of
video, photographic, audio or electronic (e.g.,
computerized) material; and copies, if possible, of any
statements or messages included.
It would be useful if you could give reason for
selecting particular items or combination of items included,
and also say exactly who made the decision(s).
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a)
Newspapers, magazines, books, or other published printed
materials:
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b)
Photographs, video, movie film, audio tapes:
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c)
Coins, medals or tokens:
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d)
Specially-produced messages or statements:
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e)
Other items (please clarify into groups if possible):
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7. Dates |
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When was the
capsule sealed and deposited?
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If an opening
date is specified, when will it be?
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Why did you or
your organization specify/not specify an opening date?
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Why was this
particular date chosen?
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8. Consultant
or Adviser |
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Was a technical
or public relations consultant/adviser used for this
project? If so, please provide the individual's or
company's information: |
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Consultant/Adviser:
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Street Address
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City
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State
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Zip
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Country
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Telephone
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Telex
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FAX
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Any other
details you think might be relevant (e.g., how did you hear
of the consultant?)
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Are you happy
with the advice you received?
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If not, please
state the grounds of your dissatisfaction.
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9. Further
contacts, future projects or ideas |
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Please give
names and addresses or other people you think might be
interested in time capsules or the work of the International
Time Capsule Society. We also would appreciate
hearing about any other projects in this field, or ideas for
the content, design, publicity or other aspects of time
capsules.
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This questionnaire should, if possible, be
completed by the individuals most directly
concerned with the time capsule.