This form must be filled out by each individual interested in visiting the Lewis-Crowder Cemetery. Full Name * Email Address * Phone * Street Address City State --Select State--AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Reason for Visit (Check all that apply) * Research Family Event Other If other reason, please describe: Describe the reason for your visit in 1-2 sentences: * Preferred Date for Visit: *MonthJanFebMarAprMayJunJulAugSepOctNovDec MonthDay12345678910111213141516171819202122232425262728293031 DayYear20212022202320242025 Year Preferred Time of Day for Visit: *Hour123456789101112 Hour:Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 Minute am pm Agreement *I understand that the Lewis-Crowder cemetery is on private property and permission is needed in advance to access the cemetery. The ability to visit the site is contingent upon approval and only after receiving confirmation from the Heritage Coordinator. This applies to all individuals, researchers, and members of heritage organizations and historical societies. Please do not contact the property owners or neighboring properties to request access to the cemetery. All requests should go through the Heritage Conservation office. All visitors proceed at their own risk. I understand and agree Leave this field blank
