Gift or Monetary Donation Application
Your name
*
First Name
Last Name
Your email
*
example@example.com
Your phone number
*
Format: (000) 000-0000
Your Address
*
What type of donation are you making?
*
Monetary
Monetary (in honor/memory of someone)
I'd like the library to purchase a book in honor/memory of someone
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The subject/topic we prefer for this book is
Would you like us to notify anyone about this donation?
Yes
No
Name of person to be notified
First Name
Last Name
Email address of person to be notified
example@example.com
Address of person to be notified
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Donation in honor of
Is this donation in memory of the person listed above?
Yes
No
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If your donation is $150 or more, would you like a name added to our Donor Wall?
Yes
No
Not applicable
Name to be added to Donor Wall
First Name
Last Name
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Donation Amount
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( X )
USD
Enter Donation Amount
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
Should be Empty: