Collector: ___________________________________Date:_______________________

School:____________________________________________ Grade Level:_______

Interviewee (include maiden name):__________________________________________

__________________________________________________________________________

Interviewee's Address: ___________________________________________________

___________________________________________ Phone: (______)____________

Parish:__________________________ Ethnic Heritage:_____________________

Circumstances of Interview:_________________________________________________

________________________________________________________________________

Interviewee's Date and Place of Birth:__________________________________________

Occupational Experience:________________________________________________

Hobbies and Interests:__________________________________________________

Folklore Collected: ____________________________________________________

_______________________________________________________________________________

Learned how, from whom, AND WHEN?____________________________________________

__________________________________________________________________________

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