Please fill out the following form and return with your remittance to the address below


 Publications Order Form


Name: ________________________________________________________________________

Street or Box No.: _______________________________________________________________

City: _______________________________State:_____Zip:______________________________

Telephone No.: ( ____) _________________E-mail:______________________________________

 Description of Item

Quantity Desired

Price Each Item
Price Total
Photo of Interior of St. Louis Church  
Photo of Exterior of St. Louis Church  
Windows of the Past  

Back Issues of Besancon, Indiana Chronicles
Indicate Issue Number(s) in Quantity Desired Column
 Total. Add purchases and place amount in the next column.  
 Indiana residents: add 5% sales tax to total.  
 If your have purchased Chronicles issues and/or Windows book add $3.50 S & H for each item.  


Besancon Historical Society
15535 Lincoln Highway East
New Haven IN 46774

 Return to BHS Home Page