Kankakee Valley Historical Society Membership Form

NAME: _______________________________________________________________________

STREET ADDRESS:_____________________________________________________________

CITY:________________________________________STATE:__________ZIP:___________

PHONE:___________________________E-MAIL:____________________________________

Please Circle One: INDIVIDUAL $30.00 or FAMILY $40.00

Please make your check or money order payable to

The Kankakee Valley Historical Society, Inc. and mail along with the completed form to:

The Kankakee Valley Historical Society, Inc.

c/o 22 West 1050 South

Kouts , IN 46347

QUESTIONS? Call John or Mary Hodson at (219) 766-2302