Donation Form
(Print and complete this form and submit it with your
donation)
Collinsville Historical Association
P.O. Box
849
Collinsville, AL 35961
Please Print
| Name: | ______________________________________________________________________ |
| Address: | ______________________________________________________________________ |
| City/State/Zip: | ______________________________________________________________________ |
| Telephone: | ______________________________________________________________________ |
| Email: | ______________________________________________________________________ |
| Donation: | __________________ |
| Comments: | ______________________________________________________________________ |
| ______________________________________________________________________ | |
| ______________________________________________________________________ |
Thank you for you support!!!