PCHS Books, CDs
and Membership Order Form
Potter County Historical Society
PO Box 605
Coudersport, PA 16915-0605
No. Copies ____ @ $12.00
(in state)
No. Copies ____ @ $11.30 (out-of-state)
I Remember When
No. Copies ____ @ $11.30 (out-of-state)
Sub
Total __________
No. Copies ____ @ $12.50 (in state)
No. Copies ____ @ $11.90 (out-of-state)
No. Copies ____ @ $11.90 (out-of-state)
Sub Total _________
Around Galeton and Coudersport
No.
Copies ____ @ 23.60 (in state)
No. Copies ____ @ 22.50 (out-of-state)
No. Copies ____ @ 22.50 (out-of-state)
Sub
Total _________
Membership in the Society (includes 4 Bulletins)
__ Please check if you would prefer to receive Bulletins by email.
Email address: _____________________________________
Your email address will NOT be shared.
One
Year @
$5.00
____________
Mann Fountain Donation ____________
Additional Donation $ ____________
Mann Fountain Donation ____________
Additional Donation $ ____________
Sub Total _________
Total
$_____________
Name _______________________________________________________
Address _____________________________________________________
City __________________________ State __________ Zip ____________
Amount Enclosed $ _______________