Lane County Historical Museum Dighton, Kansas home of the Lane County Bachelor

 

 

Lane County Historical Society

Donation Form

 

 

Name:  ______________________________________________

 

 

Address:  ____________________________________________

 

 

City:  ____________________________________

 

 

State:  _____________ Zip Code:  _____________

 

 

Amount of donation: $ ______________

 

   Select type of donation:

 

   Memorial Day Donation:  _____     Building Fund Donation: _____     General Donation:  _____

 

 

   In memory of:  ________________________________________________________________

 

 

   In honor of:  __________________________________________________________________

 

 

© 2015 Lane County Historical Society

Dighton, Kansas