Memorial Book Donation Form by cld14053

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									                            Memorial Book Donation Form
DATE                                ____________

AMOUNT ($25.00 minimum)             $_________

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IN MEMORY OF_______________________________________

Subjects person above was interested in _________________

Library will send an acknowledgement to family member(s) or friend(s) of the person above.

Name of family member(s) or friend(s): ____________________

Street:                     _______________________________________________

City, State, Zip:           _______________________________________________

Relationship to deceased: _______________________________

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DONOR’S INFORMATION

Name:                       _______________________________________________

Address of donor (library will send you an acknowledgement)

Street:                     _______________________________________________

City, State, Zip:           _______________________________________________

Phone number of donor: ________________________________

Please enclose check or money order and mail entire form to:
Reading Public Library
100 South Fifth Street
Reading, PA 19602

								
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