Cleveland County Historical Society
P.O. Box 192
Rison, Arkansas 71665
MEMBERSHIP FORM
NAME____________________________________________________________Address____________________________________________________________City/State/Zip_______________________________________________________
E-MAIL: ______________________________________
Phone: _________________________________________
DUES: Please circle your choice.
Individual Membership $15.00
Family Membership $25.00
(Please list name of spouse if family membership__________________________________________
Organization Membership…. $35.00
Date paid: _____________________________
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Please list any names that you may be researching in Cleveland County, Arkansas, and the community in which they may have lived. Please include any variant spellings of the surname and any nicknames or shortened forms of given names.
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Please list any historical documents or photographs or information; school, church, or community histories; or artifacts that you may be willing to share with the CCHS or on which you would be willing to give a program.
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