WASHINGTON COUNTY LIBRARY SYSTEM

 DONATION FORM

DONOR INFORMATION

Names(s): ________________________________________________________________________

Address: _________________________________________________________________________

City: ___________________________________ State: _______________ Zip: ________________

Day Phone: _____________________________ Evening Phone: ___________________________

 

E-mail Address: ___________________________

 

GIFT AMOUNT AND PURPOSE

 

Enclosed is my gift of $ ____________

to support library services in Washington County.

 

I would like to direct my gift to:

  • Where the need is greatest

  • Books and materials

  • Other: _________________________

MEMORIALS & TRIBUTES

 

This is a special gift:

In Memory of: ___________________________________

In Honor of: ___________________________________

Please send an acknowledgement to the honoree or next of kin listed:

Names(s): ____________________________

Address: _____________________________

City: _______________________________

State: _____________ Zip: _____________

Day Phone: __________________________

Evening Phone: ______________________

           Mail to:  Washington County Library System, 341 Main St, Greenville, MS 38701