To give a memorial, please print and fill out the form below, then mail to the Birmingham Historical Society.

Memorial in honor of:

Name______________________________________________________________________

Address_____________________________________________________________________

City____________________________________State_________Zip_________________

Your Information (to receive an acknowledgment)

Name______________________________________________________________________

Address_____________________________________________________________________

City____________________________________State_________Zip_________________

Telephone______________________E-mail____________________________________

Remittance is by:

Mail to:
Birmingham Historical Society, One Sloss Quarters, Birmingham, AL 35222
Telephone: 205-251-1880, Fax: 205-251-3260