Indiana Pioneer Cemeteries Restoration Project Survey Form

Indiana Pioneer Cemeteries Restoration Project Grave Survey Sheet

Instruction: Complete one of these forms for each grave using a pencil. Watch for grave markers with more than one person. Be sure to note any special conditions or other information about the grave site or marker. When possible, attach a photograph of the grave marker. Always have someone else double check your work for accuracy.

Grave Number or Coordinates

Location of Cemetery

Name of Cemetery___________________________________________________________

City or Town____________________ County_______________ Township_______________

Directions to Cemetery________________________________________________________

_________________________________________________________________________

Religious or organizational affiliations______________________________________________

Data From Grave Marker

Name of deceased__________________________________________________________

Birth Date___________ Date Died____________ Age at Death____yrs ____months ___days

Name of Spouse____________________________________________________________

Name of Children___________________________________________________________

Military unit____________________________________________ Killed in Action?_______

Other information___________________________________________________________

________________________________________________________________________

Grave Marker Characteristics

Circle closest style:

Description_________________________________________________________________

_________________________________________________________________________

Height______ Width_______ Material___________________________________________

Condition__________________________________________________________________

_________________________________________________________________________