Make a Lasting Gift
Please Print
Name ____________________________________Phone______________
Street _______________________________________________________
City________________________________ State _____ Zip ___________
I
will contribute: ____$15 ____$25 ____$50 ____ $75 ____$ 100
____other
Medium: ____ book ____ magazine subscription ____ compact disc
____book-on-cassette ____videocassette ____ unspecified ____
other
Preferred title or subject(s): ______________________________________
____adult dept. ____ children's dept. ____ either
Circle one and fill in the blank:
a. In Honor Of: _________________________________________________
b. To Commemorate: _____________________________________________
c. In Memory Of: ________________________________________________
d. In Appreciation Of: _____________________________________________
Individual to be notified about your donation:
Name _________________________________________________________
Street _________________________________________________________
City ____________________________________ State ____ Zip __________
Please enclose your check made payable to: Avon Free Public Library.
Cut out form and return with check to: Director, Avon Free Public Library,
281 Country Club Road, Avon, CT 06001
Thank you for your tax-deductible donation.