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WEST mCOUl/ER HISTORICAL SOCIETY CONTACT RECORD Date:, Staff: Donors Name Address City Phone H ( ) . 0 ( ) , Postal Code Original Owner or Source Place of Residence Birth & Death Dates Occupation/Busi ness Status of Material: Comments re Status Restri ctions: Gift: ............ Loan; Purchase Description Comments Correspondence Scrapbooks Di aries Painti ngs Movie (s) Phamphlets ____ Clippings .... Photos .... Printed Matter Other .... Letterbopks Books Maps Tapes Contact: Personal Visit W.V.H.S. Meeting Phone Call Correspondence Assoc. Member Date