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Nottawa
Township Library Memorial Book Donation Form
Date
________________
I
am donating $____________
for materials to be placed in the library as a
memorial
for:
________________________________________________
I
would like the following message placed on a bookplate in the
book: _____________________________________________________________
--OR--
In
honor of:
__________________________________________________
I
would like the following message placed on a bookplate in the
book: _______________________________________________________
_______________________________________________________
Do
you wish your name to be entered on the bookplate as the donor?
Yes
or
No
Would you like this donation to be used
to purchase a specific title, author, or subject area?
_________________________________________________________________________
Do
you want anyone notified of this donation?
Name
__________________________________
Address
________________________________
City,
State, Zip ___________________________
Please
complete the following:
Donor’s
Name ___________________________
Address
________________________________
City,
State, Zip __________________________
Checks
should be made out to Nottawa Township Library
Please
return the completed form to the Circulation desk. A copy will be made for the donor.
Approved
by Nottawa Township Library Board:
February 22, 2006 To
be Reviewed: February
2008
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