CENSUS FORM Release 2.0 (June 2001)

MAIN PAGE

Id Number:	XXXX (this will be automatically given by the web master)	
Record Date:	month – day - year (the date of filling of this form)	
Country:	State where the exemplum is located	
Location:	Address (street, number, city)	
Denomination:	name given to the architecture (usually derived from owner or designer)	
Typology:	name in original language (i.e. villa, theatre, City Hall etc…)	
Period:	i.e. 1907-1910 (range of construction period)	
Style:	in original language (i.e. Liberty, Floreale, Decò, Neo-Renaissance etc.)	
Architect::	name of designer	
Bibliography:	Relative to exemplum	
Author of form:	Name, Surname, address, eventual Body and its address, e-mail	

Façade photograph	Insert image JPEG format here	

Artificial stone elements: 
pediment 		
door surround		
window surround 		
balustrade 		
column 		
pilaster 		
capitel 		
quoining 		
rustication and stucco 		
corniche 		
decorative panel 		
armorial panel 		
soffit 		
balcony 		
braquet 		
niche 		
statue 		
vase 		
other...		
(INSTRUCTIONS: the right column of the above chart contains just a “X” letter for each studied element that will be characterized ,each one, by the following page subform)

FOLLOWING PAGE(S)

Id Number:		
Record Date:	Repeated data from main page	
Country:	Repeated data from main page	
Location:	Repeated data from main page	
Denomination:	Repeated data from main page	
Typology:	Repeated data from main page	
Period:	Repeated data from main page	
Style:	Repeated data from main page	
Architect::	Repeated data from main page	
Bibliography:	Repeated data from main page	
Author of form:	Repeated data from main page	
Image	Insert image JPEG format here	
Image caption	Description of the above image	

INSTRUCTIONS:The following voices are relative to each one of the architectonic elements highlighted (with an “X”) in section “Artificial stone elements” on the main page. Subvoices must be highlighted with an “X” where occur or extensively descripted.

Materials: 
Air lime 		
Hydraulic lime 		
Portland cement 		
Gypsum plaster 		
Gypsum lime plaster 		
other...		
notes		

Techniques: 
molding in situ 		
prefabricated molding 		
hand modeling 		
casting in situ 		
prefabricated casting 		
other...		
notes		

Surface treatment: 
bush hammered 		
combed		
rubble 		
smoothed		
other...		
notes		

Surface finishing: 
lime wash 		
linseed oil paint 		
tempera paint 		
plastic paint 		
silicate paint		
other...		
notes		

Condition: 
crazing 		
cracking 		
delamination 		
detachment 		
powdering		
other...		
notes		

References:		

General notes:		

Acknowledgments: