Roadshow’s 2017 Furniture Roundup Form
Please complete one form and include at least one photograph per item of furniture you are
submitting. The photograph(s) of your items will not be returned.
Event City (Circle one):
•
JUNE 3 — Harrisburg, PA
•
JUNE 17 — Green Bay, WI
•
JULY 8 — St. Louis, MO
•
JULY 22 — New Orleans, LA
•
AUGUST 12 — Portland, OR
Contact Information:
Owner’s First Name: ________________________________________________________
Owner’s Last Name: ________________________________________________________
Street Address: ____________________________________________________________
City: _____________________________________________________________________
State: _______________________________ ZIP Code: ____________________________
Phone Number: _________________________ Alt Phone: _________________________
Antiques Roadshow | WGBH Boston | One Guest Street | Boston, MA | 02135
Furniture Information:
What type of furniture are you submitting?
Approximate weight of your piece of furniture:
Approximate dimensions of your piece of furniture:
How did you acquire this piece of furniture?
If you purchased the furniture, how much did you pay and when?
Antiques Roadshow | WGBH Boston | One Guest Street | Boston, MA | 02135
Have you ever had this piece of furniture appraised? If so, when? What was the approximate
appraisal value at the time?
If your item is selected, the owner must attend the event.
Can the owner attend the event? Circle one: YES or NO
Please describe your piece of furniture and anything you know about its history and provenance:
Antiques Roadshow | WGBH Boston | One Guest Street | Boston, MA | 02135