PETERS-STEVENS BOAT ANNEX DONATION FUND
Print this form
Mail the completed form to:
Henderson Historical Society
Att: Peters-Stevens Fund
PO Box 322
Henderson, NY 13650
Nameof Donor(s): ____________________________________________________
Address: ______________________________________________________
City $ State & Zip:_____________________________________________________
Total Amount Enclosed: ____________________________
Name(s) to appear on Donor Registry: _________________________________________
Make Checks payable to:
Henderson Historical Society.