HONORARIUM/MEMORIAL FORM

GIVEN BY - NAME:___________________________________________________________________              ADDRESS:________________________________________________________________                      CITY:_________________________________STATE:________ZIP:_________________

 

THIS GIFT IS GIVEN:                           In Memory of                                     In Honor of

                                                                                                    (circle one)

NAME:_____________________________________________________

 

SEND ACKNOWLEDGEMENT TO – NAME:  _______________________________________________

                                                                                  ADDRESS:  ___________________________________________

                                                                                    CITY:  ______________________STATE:_______ZIP:________

_______________________________________________________________________________________________

                                                                                     PLEASE RETURN FORMS TO:

                                               CAMPBELL COUNTY HISTORICAL & GENEALOGICAL SOCIETY

                                                                                     8352 EAST MAIN STREET

                                                                                      ALEXANDRIA, KY  41001   

 

 

 

 

HONORARIUM/MEMORIAL FORM

GIVEN BY - NAME:___________________________________________________________________              ADDRESS:________________________________________________________________                      CITY:_________________________________STATE:________ZIP:_________________

 

THIS GIFT IS GIVEN:                           In Memory of                                     In Honor of

                                                                                                    (circle one)

NAME:_____________________________________________________

 

SEND ACKNOWLEDGEMENT TO – NAME:  _______________________________________________

                                                                                  ADDRESS:  ___________________________________________

                                                                                    CITY:  ______________________STATE:_______ZIP:________

_______________________________________________________________________________________________

                                                                                     PLEASE RETURN FORMS TO:

                                               CAMPBELL COUNTY HISTORICAL & GENEALOGICAL SOCIETY

                                                                                     8352 EAST MAIN STREET

                                                                                      ALEXANDRIA, KY  41001