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               DIRECTORY OF AMERICAN SCHOLARS QUESTIONNAIRE

Please return within 10 days of receipt

Gale Research
835 Penobscot Bldg.
Detroit, MI 48226-9948
TEL (313) 961-2242, ext. 1757
FAX (313) 961-6815
E-MAIL [log in to unmask]

Address after September 15, 1998:
27500 Drake Rd.
Farmington Hills, MI 48331-3535


**Information is currently being collected for an updated edition of the Directo
Scholars. If you are a humanities scholar (doctoral degree or equivalent; active
publishing scholarly works), please provide the information requested below. (Yo
already received a revision form with currently existing data from us. If so, pl
request.)
**There is absolutely no charge for this listing.  Attach additional sheets as n

#

NAME
_Prefix:
_First Name:
_Last Name:
_Suffix:
_Alternate Name:

MAILING ADDRESS
_Organization (ie: University):
_Street Address:
_PO Box:
_City:
_State/Province:
_Zip Code:
_Country (if other than USA):
_Email:



PERSONAL INFORMATION
_City of Birth:
_State of Birth:
_Country of Birth:
_Date of Birth (MM/DD/YYYY):
_Marital Status:
_Year of Marriage:
_Number of Children:

_Education (School, degree, year):



_Discipline/Major:



_Professional Career (include years, title/position, institution, etc.):





_Honors and Awards:




_Professional Memberships:



_Research Interests:


_Publications (extensive lists will be limited to the last 5 years):




#

Prepared by: _____________________________________
Date:_____________________________