PREFACE. Xlir 



12. Form of Application for Publications. 



To the Smithsonian Institution, Washington, D. C. 



Date, 18 



In behalf of the , we respectftilly apply 



for the publications of the Smithsonian Institution, on condition that all vol- 

 umes received shall be carefully preserved, be accessible to any person who 

 may wish to consult them, and be returned to the Smithsonian Institution in 

 case the establishment at any time ceases to exist. 



1. Name of Establishment 



2. Location — Town 



State 



3. When established -. 



4. Character 



5. Buildings and property 



6. Permanent fund , 



7. Annual income 



8. Volumes in library 



9. Number of persons having use of books 



10. Date of last catalogue of library 



II. What publications made 



(Send printed list if possible.) 



12. Names of Officers : President. 

 Secretary . 

 Librarian - 



13. Addresses of principal scientific men connected with the Establishment and subjects in 

 which specially interested 



I recommend the above application. 



Member of Congress, 



District.. State. 



