The Reed Organ Society, Inc.
                    An International Organization
                    Reed Organ Registration Form

Owner's Name ( ) or person reporting ( )_______________________________
Address______________________________________________________Zip_______
Telephone Number (___)___-___________        Date _____________19______
Is this organ in a public building (Y/N)_____ Photo enclosed (Y/N)_____
If yes, where?_________________________________________________________
Is the organ in playable condition? (Y/N)______________________________
 
                             ORGAN INFORMATION
 
Make (Brand) of Reed Organ____________________City of Maker____________
Model or Style____________ Serial No._____________Case Wood____________
Year or Date Made_______________Pitch:__________Compass: F____ or C____
Stops break between Bass & Treble (Y/N)_____  If so, at keys#____&#____
Case Style: Lyre-leg Melodeon ( )  "Piano" style Melodeon ( )  Baby ( )
Flat-top ( )  Folding ( )  Chapel (finished back) ( )   Piano  Case ( )
Harmonium ( )  Parlor (with or without top) ( )  Lap ( )  Rollplayer( )
Two or three manual  ( )  with Pedal  ( )  Other ( )___________________
Wind: Suction ( ) Pressure ( ) Pumped by Foot ( ) Handle ( ) Blower ( )
No. of keys:_____(1 manual) No. of keys_____G_____S_____C  (2-3 manual)
No. of Pedal keys:____Pedalboard flat?_____Concave?_____Radiating?_____
 
Please  list  stop  names and pitches, left to right.  If a stopface is
missing, leave a blank.
 
                            2 - 3 manuals (list by pitch)
       1 manual
                               GREAT                      SWELL
 1._________________    1.___________________     1.___________________
 2._________________    2.___________________     2.___________________
 3._________________    3.___________________     3.___________________
 4._________________    4.___________________     4.___________________
 5._________________    5.___________________     5.___________________
 6._________________    6.___________________     6.___________________
 7._________________    7.___________________     7.___________________
 8._________________    8.___________________     8.___________________
 9._________________    9.___________________     9.___________________
10._________________   10.___________________    10.___________________
11._________________   11.___________________    11.___________________
12._________________   12.___________________    12.___________________
13._________________ 
14._________________            PEDAL                   CHOIR/SOLO
15._________________    1.___________________     1.___________________
16._________________    2.___________________     2.___________________
17._________________    3.___________________     3.___________________
18._________________    4.___________________     4.___________________
19._________________    5.___________________     5.___________________
20._________________    6.___________________     6.___________________
 
Thank you for registering your reed organ.  Any unusual features should
be described.  You'll receive a Registration Label which can be affixed
to the instrument. Your organ will be included in an historical account
of extant reed organs.  If you  have a large collection, we can arrange
to assist you.  Your address  and telephone number will NOT be included
in computer-accessible files.
 
__________________________________snip_________________________________
 
S-mail:                                 E-mail:
 
Don Swett				don_swett@earthlink.net
595 S. Alton Way #3D
Denver, CO 80247

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John K. Estell - 9 April 2007