Questionnaire For
Jerry Slocum's Directory of
Puzzle Collectors and Puzzle Sellers

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If you would like to be in future editions of Jerry Slocum's Directory of Puzzle Collectors and Puzzle Sellers, you may fill in the following information. Keep in mind that this directory is for serious puzzle collectors and the information is so other collectors can find you, not just to get your name in the directory. The information you provide in this questionnaire is the same kind you will receive for about 500 collectors from all over the world and they expect the same level of detail.

If you are already in the directory, you can update your entry by so indicating, filling in your name, email address, and all fields you want to change.

This information will be emailed to Jerry Slocum and a copy will be emailed to you and the Puzzle World webmaster. The information provided in this form will not appear in any form in Puzzle World. It is for the exclusive purpose of enhancing Jerry Slocum's Directory of Puzzle Collectors and Puzzle Sellers.

Phone numbers must be entered in the  common international dialing format: +[country code]-[city or area code]-[number].

 
This is an update to my existing entry (You only need to fill out your 
name and all parts that have changed from the May 2000 Directory)
   
Please delete my directory listing
   
Name:
Email Address:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Home Phone: e.g. +1-513-555-7653
Mobile (Cell) Phone: e.g. +1-513-555-7653
Work Phone: e.g. +1-513-555-7653
Fax: e.g. +1-513-555-7653
Home Page:
Spouse's Name: *
Children's Names: *
* Used at IPPs, not published in directory
Check or fill in all that apply
I collect puzzles:
I design puzzles:
I make puzzles:
I am a woodworker:
I am a magician:
I collect games:

I am a teacher:
I use puzzles in my classes:
I am interested in puzzles in education:
Other
I sell puzzles by mail order: *
I sell puzzles at my retail store: *
* Please complete the appropriate Mail Order or Retail Store sections below
Puzzle Interest (If you are unsure about the classification, check out the Puzzle Categories page)
None Some Main
Put-Together Puzzles
Take-Apart Puzzles
Interlocking Solid Puzzles
Disentanglement Puzzles
Sequential Movement (Moving parts of the puzzle towards a goal)
Dexterity (Manual dexterity is key to solving the puzzle)
Puzzle Vessels (Puzzle jugs and mugs, Cadogan teapots, Chinese wine pots, etc)
Vanish (Loyd's Get Off The Earth, Vanishing Leprechauns, etc.)
Folding (Flexagons, Fifth Pig, etc.)
Impossible Objects (Arrow Through Bottle, Harry Eng's Bottles, etc.)
I started collecting in: (Year)
My collection size is: Antique (Prior to 1920) Puzzles
Older (1921 to 1980) Puzzles
Modern (After 1980) Puzzles
I have added puzzles to my collection in the past 12 months
My main puzzle interests are:
I also collect (other than puzzles):
I have the following puzzles for sale:
I would like to hear from other collectors about:
My favorite puzzle stores are:

Include addresses, what is sold, etc.
My favorite Internet sites are:

You had better get this one right!
Biographical (career, family, interests, etc.)

I would like to be invited to Puzzle Parties in:The U.S.A Europe Japan

Please email your portrait photo as an attachment to:

You may list my directory information on a secure, password protected web site.

Enter any additional information you would like included, including questions about this form:
---MAIL ORDER---
Complete this section if you sell puzzles by mail order
Business Name:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone: e.g. +1-513-555-7653
Fax: e.g. +1-513-555-7653
Email Address:
Web Site:
Manager's Name:
Mechanical Puzzles Sold:
Include type and makers:
You may use this information in a web site:
---RETAIL STORE---
Complete this section if you sell puzzles in your retail store
Business Name:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone: e.g. +1-513-555-7653
Fax: e.g. +1-513-555-7653
Email Address:
Web Site:
Manager's Name:
Mechanical Puzzles Sold:
Include type and makers:
Days / Hours Open:
 
Descriptive Location:
I.e. In Town Mall, in central train
station, closest subway, etc.:
You may use this information in a web site:

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