LGBTQ Site Submission Form - Preservation Connecticut

Name *

First

Last

Email *

Site Name *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Brief history and/or significance of the site in LGBTQ history *

Please also note your information’s sources.

Building Image Upload *

Click or drag a file to this area to upload.

Image Upload (optional)

Click or drag a file to this area to upload.

Phone