|Jersey County Historical Society Monetary Donation
To make a monetary donation, please print and complete this form, and mail it and your check (made
payable to the Jersey County Historical Society) to:
Jersey County Historical Society
601 N. State Street
Jerseyville, Illinois 62052
Your Name: _______________________________________________________________
I would like to make a monetary contribution to the Jersey County Historical Society and would like this
money used for: (If you have a preference, please check one of the following options. If you do not make
a choice, the money will be used for the upkeep of our buildings and grounds, etc.)
___ The Cheney Mansion ___ The museum's military room
___ The Lone Star School ___ The museum's domestic rooms
___ The McAdams log cabin ___ The museum's transportation room
___ The Union Forest Church ___ The Jersey County Historical Society
___ The Genealogy Research Center ___ Other _______________________________
Please use this money as a memorial fund in the memory of _________________________________.
If your donation exceeds $25, we will mail you a receipt, which can be used for tax purposes.
Questions? Call us at 618-498-3514 or email us at email@example.com.