5.75x8.5" Telegram form with a message from sculptor Paul Chevré on April 17, 1912 saying that he has survived the TITANIC disaster. The form includes the time it was sent, the fee, and the initials of Harold Cottam, CARPATHIA's wireless operator. The rear of the form has the Marconi Company's terms and conditions including a waiver of liability, and an advertisement for Selfridge's store in London.