Ohio Historical Markers Application Form

Thanks for your interest in Ohio Historical Societys Historical Markers program. Please complete this application to apply for
an official state historical marker. Type or print clearly and please include all information requested. Incomplete applications
will be returned. While submission of an application does not guarantee that a marker will be awarded, we appreciate your
efforts to provide the information required and look forward to working with you. Contact the Ohio Historical Societys Local
History Office if you have any questions: (614) 297-2340, toll-free 1-800-858-6878, or e-mail tsheline@ohiohistory.org or go to
www.remarkableohio.org or www.ohiohistory.org/resource/oahsm/markers.html
Check the box if applying for funding through Ohio Historical Markers Grants Program. Deadlines for applications
for grant funding are April 1 and October 1. Funding is competitive. For more information about the markers grant
program, go to www.remarkableohio.org or www.ohiohistory.org/resource/oahsm/markers.html

1. Title of Marker: ________________________________________________________________________

Title of historic property, person or event; archaeological, geological or natural history event or site; or ethnic or
legendary event or site to be marked.

2. Classification of site, property, or place to be marked

OWNERSHIP OF PROPERTY (Please check one)
public, local
public, state
public, federal
CATEGORY (Please check one)
historic event
historic person
historic building
archaeological site
natural history
ethnic association

historic district
geology
legend

private
Other Please describe: _____________
__________________________
__________________________

New for the Ohio Civil War Sesquicentennial! Civil War-related marker topic? Check the box to have a full-color Ohio
Civil War 150 logo included on your marker for an additional fee of $50. Fee supports Ohio Historical Societys efforts to
commemorate the Civil War, www.ohiocivilwar150.org
Yes, include the Ohio Civil War 150 logo on our Civil War era-related marker

3. Location of the Proposed Marker

Include a written description, a marked map showing proposed placement of marker, and a photograph of the location. If
applicable, note the relationship of the location to the site being marked.

Property Name (if applicable): ______________________________________________________________________

Street and Number: ____________________________________________________
City or Village: _______________________

County: ________________ State & Zip: _________________________

(Include 9 digit Zip code)

Marker GPS coordinates (if known): Latitude: __ __. __ __ __ __ __ __ Longitude: (-) __ __. __ __ __ __ __ __ __
Indicate relevance of location to topic of marker: _________________________________________________________
Tentative marker dedication date: ________________________________________. Note that the marker process can take
up to six months from receipt of application. It is advisable to schedule a dedication ceremony after our office has confirmed
with you the anticipated delivery date, or after the historical marker has been delivered to you.

4. Owner of Property upon which marker is to be erected

When a marker is erected on private property, the owner of the property must grant permission in writing. Please include
a copy of the grant of permission with this application.
Name: _____________________________________________ Signature: ___________________________________
Street and Number: _________________________________________________________________________________
City or Village:

State & Zip: __________________________________

Telephone: (_______)_________________________________ Fax: (_______)________________________________

Revised August 30, 2011

E-mail:_____________________________________________ Website: _____________________________________

Revised August 30, 2011

5. Type of Marker (Please check one)

_____ HISTORICAL MARKER

ART WORK (for historical markers only)

Same text each side

Metal plate photo to be included (prices vary)

Different text each side

Custom art work to be included (prices vary)

_____ 1 Text

_____ 5/8 Text

Please attach all proposed art work

_____CORPORATE LIMIT MARKER(S)

Number of markers requested
6. Funding sponsor of the marker
Applicant or sponsor is responsible for funding the marker. This includes the purchase of the marker and other costs
associated with the installation of the marker. Organization providing funds for the marker:
Name of Organization: _____________________________________________________________________________
Contact Person: ____________________________________________________________________________________
Street and Number: _________________________________________________________________________________
City or Village:

State & Zip: ___________________________________

Telephone: (_______)_________________________________ Fax: (_______)_________________________________

E-mail:_____________________________________________ Website: ______________________________________
Tax-Exempt:

Y or N

Tax-Exempt Number: ___________________________________

Note: the organization indicated above will be listed on the bottom of the marker as its lead sponsor, along with the Ohio
Historical Society. If more than one organization is to be credited, please list the names of the organizations under
Additional funding sponsor below. Because of space limitations at the bottom of marker, no more than 4 sponsors total
will be listed: lead sponsor indicated above, OHS, and two Additional funding sponsors
Additional funding sponsor: _________________________________________________________________________
Additional funding sponsor: _________________________________________________________________________
7. Maintenance of the marker
Organization responsible for the ongoing maintenance of the marker:
Name of Organization: ______________________________________________________________________________
Contact person: ____________________________________________________________________________________
Street and Number: _________________________________________________________________________________
City or Village:

State & Zip: ___________________________________

Telephone: (_______)_________________________________ Fax: (_______)_________________________________

E-mail:_____________________________________________ Website: ______________________________________
8. Shipping Address A commercial address with the name of an office or shop open between 8 am 5 pm, Monday
Friday. It is the responsibility of the receiver at the shipping address to inspect the marker prior to accepting delivery.
Name of organization: _______________________________________________________________________________
Contact Person: ________________________________________________________________

________

Street and Number: _________________________________________________________________________________

City or Village:

State & Zip: __________________________________

Telephone: (_______)_________________________________ Fax: (_______)________________________________

Revised August 30, 2011

E-mail:_____________________________________________ Website: _____________________________________

9. Statement of Significance
Explain why the person, place, event, or thing to be marked is significant at the local, state, and/ or national level. In
other words, why does the person, place, event, or thing you want to mark deserve recognition with an Ohio Historical
Marker? THIS SECTION MUST BE TYPEWRITTEN. Please limit the statement of significance to one typewritten page.

10. Suggested Marker Text

Draft a suggested marker text of between 60 - 130 words and keep in mind that the text must be concise, informative, and
historically accurate. THIS SECTION MUST BE TYPEWRITTEN. Be sure to document all statements of fact in your
suggested marker text with footnotes or endnotes1. The purpose of footnotes/endnotes is to tell others where you found
the facts in the suggested marker text. Including footnotes/ endnotes in the suggested text also greatly aids the process of
reviewing and fact-checking. Please note that footnotes/endnotes will NOT be included on the finished marker.
Suggested texts are subject to change.

This is a footnote. Please make sure each note includes the following information: AUTHOR of source, TITLE, PLACE OF
PUBLICATION, DATE OF PUBLICATION, and PAGE NUMBER.
This format, for example, is the one typically used in historical writing: Charles Van Tassel, Story of the Maumee Valley, Toledo and
Sandusky Region (Chicago: S.J. Clarke Publishing Company, 1929), pp. 18-19. However, the markers program is more concerned
with knowing the sources the information rather than the formats of footnotes or endnotes. Whatever format is used, a good
footnote/endnote answers these questions: What is the source of this fact? and What source must I consult to find this fact for
myself?
If the source is a web page, please include the link in your footnote, for example: Ohio City (City of Ohio) Encyclopedia of
Cleveland History at http://ech.case.edu/ech-cgi/article.pl?id=OC1
It is not necessary to repeat information if your referring to the same source many times throughout your suggested text, just include
the author, title, and page number. Using the example above: Van Tassel, Story of the Maumee Valley, p. 28
Revised August 30, 2011

11. Sources and Bibliography

Please list the publications or other references cited in the footnotes/endnotes in question #10 above. Please also attach
to your application photocopies of the relevant pages (not the whole book). For each reference, note the name of the
author, the title of the source, its place and date of publication, and page numbers. Be sure to match which
footnote/endnote goes with what photocopied source attached. If it is impractical to photocopy the source, please
indicate where it may be found so that it may be consulted when this application is reviewed. Applications missing
sources and a bibliography will be returned.

12.

Application Submitted By

Please note: All applicants must complete Section 12

I have verified that the above information is accurate and correct to the best of my knowledge. I will fund and maintain
the marker, or I am authorized to commit the person or organizations named above to fund and maintain the marker.
Signed: _____________________________________________ Date: ________________________________________
Printed Name: _____________________________________________________________________________________
Name of Organization: ______________________________________________________________________________
Street and Number: ________________________________________________________________________________
City or Village:

State & Zip: ___________________________________

Telephone: (_______)_________________________________ Fax: (_______)_________________________________

E-mail:_____________________________________________ Website: ______________________________________

Send or e-mail completed application and supporting materials to:

Historical Markers Program Coordinator
Local History Office
Ohio Historical Society
800 E 17th Avenue
Columbus, Ohio 43211-2474
tsheline@ohiohistory.org
Questions? Call (614) 297-2340 or toll-free 1-800-858-6878, or email tsheline@ohiohistory.org or go to our websites at
www.remarkableohio.org or www.ohiohistory.org/resource/oahsm/markers.html
______________________________________________________________________________________________________________________

FOR OFFICE USE ONLY. To be filled out by Historical Markers Program Coordinator.
Complete Application Received: _______________________________________
Marker(s) Erected:

Applied for Funding:

Received Funding:

Revised August 30, 2011

Date:
Date: