First Name

Last Name

Address

Phone Number

Email Address

If you would like to include a second email for spouse, significant other, etc. please do so.

2nd Email Address

Please choose your support level from the options listed below. Payment can be made by cash or check.

Squire Boone - $2,000 (Business logo on website, social media & all printed publications)Whitney M. Young, Jr. - $1,000 (Name listed on website, social media, printed publications)Daisy Saffell - $500 (Name listed on website & social media)Abraham Rothchild - $250 (Name listed on website & social media)Julia Tevis - $100 (Name listed on website)Thomas Baxter - $75Edwin Hubble - $50The Old Sexton, Mr. Moesser - $25Other

After clicking submit, please print out the form and attach your payment. Either mail the form or drop it off at the address below.

Mail to: SCHS, P.O. Box 444, Shelbyville, KY 40066-0444
Drop off: 627 Main Street, Shelbyville, KY 40065