Complete this form, print it, and send it (with your check) to:

West Baden Historical Society
PO Box 284
West Baden Springs IN 47469

Member information:

Name
Address
City
State
Zip
Phone
Email
Business

 

Please note: The form does not calculate totals. Please enter quantity and total due.

	Item	Price each	Quantity	Total Due
	1 year membership	$10
	Lifetime membership	$100
	Please add my tax-deductible donation

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