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Cullom-Davis Library

Please Print Off the Following Form:

Book Endowment Fund

The enclosed check for $___________ is sent (please check one)

  From: __________________________________

in memory of,      in honor of,      in my name

            Name
_________________________________________________             __________________________________

(name of person as it is to appear on plaque)

            Address
_________________________________________________             __________________________________

(name of donor as it is to appear on plaque)

            City, State, Zip
             __________________________________

Please notify of gift:

             Phone

_________________________________________________
Name

Please make checks payable to:
Friends of Cullom-Davis Library

_________________________________________________
Address

Designate on check: Book Endowment Fund

_________________________________________________
City, State, Zip

If your employer has a Matching Gift Program, please call the Library at 677-2821.
All contributions are tax deductible.