BELGRADE COMMUNITY LIBRARY

106 N BROADWAY

BELGRADE, MT 59714

388-4346

www.belgradelibrary.org

MEMORIAL DONATION FORM

 

Please circle one to indicate type of bookplate to be used:


In Honor of

In Memory of

No Bookplate Necessary


Please circle to indicate type of item purchase desired:


Nonfiction ($25 minimum)

Fiction ($25 minimum)

Juvenile ($20 minimum)

Young Adult ($20 minimum)

DVD ($20 minimum)

Book on CD ($20 minimum)


OTHER_______________________

PLEASE PRINT:

 

Would you like the items to be purchased for a specific collection area or genre?

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Name of person for whom donation is given as it should appear on the bookplate: ______________________________________________________________________________

 

Name and address of person/family to whom an acknowledgement should be sent:

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Donorís name as it should appear on bookplate and address:

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Amount of Donation: $___________________________________________________________

 

If you have any questions or comments please contact the Library Director at 388-4346. Please make your check payable to the Belgrade Community Library.† Donations may also be made to the Belgrade Community Library Foundation which is a 501(c) 3 organization.

 

Return this form to the Library Director or mail to Belgrade Community Library at the above address.