Please provide your name and contact information should I wish to interview you further regarding your responses:

Name:

Street Address:

Mailing Address:

City, State, Zip:

Phone:

E-mail:

__________________________________

May I quote from your responses and identify you by name and town? Yes or No

OR

May I quote from your responses if I keep your identity anonymous? Yes or No

__________________________________

Part One
Think of a middle westerner you know well, someone you admire. Who is this person, and what is his/her relationship to you?

 

What is this person's gender?
M or F

What is/was this person's occupation?


What five traits do you most admire about this person? Or what are the person's five greatest strengths? Please list these:

 

Please tell me a story from this person's life that illustrates each of the five traits you've listed. What experiences has the person had that show he/she is what you've described? Take as much space (or as little space) as you need:

 

List what you perceive as this person's weaknesses:

 

Please tell me a story from this person's life that illustrates each of the weaknesses you've listed. What experiences has the person had that show he/she is what you've described? Take as much space (or as little space) as you need:

 

Has this person always lived in the middle west? If not, what brought him/her to the middle west? Please explain:

Can you shed any light on this person's relationship to the place(s) he/she has lived? What story can you tell that illustrates the relationship?



Is there anything else you'd like to add about this person's relationship to the place(s) he/she lives/lived?



Part Two
What is your gender?
M or F

What is/was your occupation?

What five traits are most admired about yourself? Or what are your five greatest strengths? Please list these:

 

Please tell me a story from your life that illustrates each of the five traits you've listed. What experiences illustrate the strengths you've described? Take as much space (or as little space) as you need:

 

List what you perceive as your weaknesses:

 

Please tell me a story from your life that illustrates each of the weaknesses you've listed. What experiences have you had that illustrate the weaknesses you've described? Take as much space (or as little space) as you need:

 

Have you always lived in the middle west? If not, what brought you to the middle west? Please explain:



What can you tell me about your own relationship with the place(s) you have lived? What story can you tell that illustrates the relationship?

 

If you have the resources to live anywhere you wished, where would that be, and why?

 

What things would you most like to change about your present circumstances?

 

Is there anything else you'd like to add about your relationship to the place(s) you live/have lived?


For residents of the Vagabond's "focus" towns: Would you be interested in keeping a journal of your life and experiences to be shared as part of this project, to help illuminate your relationship to your place and the people you live with? Yes or No

(The focus towns are: Eaton, Ohio; Fowler, Indiana; L'Anse, Michigan; Vandalia, Illinois; Ripon, Wisconsin; Alexandria, Minnesota; Emmetsburg, Iowa; Maysville, Missouri; Smith Center, Kansas; West Point, Nebraska; Redfield, South Dakota; and Rugby, North Dakota.)