Text Box: Langlade County Historical Society
P.O. Box 393
Antigo, WI 54409

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Text Box: Langlade County Historical Society 440 Club

$5,000____ $2,500____ $1,000____ $500____ $250____ $100____ Other______

I would like to make my pledge in ____ payments. Final payment(s) due June 1, 2006, or by arrangement.

Name: ___________________________________________________ Phone: (___)_______________
Street: __________________________________ City: ___________________ State: _____ Zip: ________

Signature: ____________________________________________ Date: ____________________

Please make pledge payable to Langlade County Historical Society 440 Club
and mail to: LCHS 440 Club, P.O. Box 393, Antigo, WI 54409

Your pledge qualifies as a tax-deductible, charitable contribution