Collection Donation Form Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Description of Item(s)*What is the historical significance?*What are the item’s connections to Brenham and Washington County?How big is/are the item(s)?Describe the condition of the item(s).*Are you hoping to:* Donate the item(s) Loan the Item(s) Sell the Item(s) Do you own the item(s)?* Yes No If no, who is the owner? Are you a current member of the Brenham Heritage Museum?* Yes No Mailing List Please add me to your email list for updates about Brenham history, activities and BHM. PhoneThis field is for validation purposes and should be left unchanged.