| Ben Avon Area Historical Association | |||
|---|---|---|---|
| c/o 136 Dickson Avenue, Ben Avon, PA 15202 | |||
| Name | |||
| Address | |||
| Phone | |||
| Item | Number | Price | Total |
| The Dixmont State Hospital DVD | $12 | $ | |
| Dixmont State Hospital (Book) | $15 | $ | |
| 1992 Ben Avon Centennial History | $10 | $ | |
| 7th Anniversary of Emsworth Borough | $10 | $ | |
| Ohio Township Bicentennial History Book, by Darlene Philips | $15 | $ | |
| Dear Emsworth, by Jim Knox | $10 | $ | |
| Subtotal | $ | ||
| Shipping & Handling | $5.00 | ||
| Make checks payable to Ben Avon Area Historical Association | TOTAL | $ | |
Please print this form and send it to the address above.