Memorial Honorary Book s Purchase In honor memory of

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					                           Memorial & Honorary Book(s) Purchase

In honor / memory of: ______________________________________________________________

Other information for bookplate: _____________________________________________________

_________________________________________________________________________________

Donated by:

        Name: _____________________________________________________________________

        Street Address: _____________________________________________________________

        ___________________________________________________________________________


Notification of gift to:

        Name: _____________________________________________________________________

        Street Address: _____________________________________________________________

        ___________________________________________________________________________


Donation amount: _____________________________ Date: ______________________________


Suggested book title(s) or areas of interest: ___________________________________________

_________________________________________________________________________________
*Note: Materials purchased through this program must meet the requirement of the BDL
Collection Development Policy.


Please call Diana Dart, Community Relations Coordinator, 810 229-6571, ext. 211, with any
questions. Checks should be made out to the Brighton District Library and mailed to:

Attn: Diana Dart
Brighton District Library
100 Library Drive
Brighton, MI 48116

---------------------- TO BE COMPLETED BY BRIGHTON DISTRI CT LIBRARY STAFF ----------------------

Title(s) selected: __________________________________________________________________

_________________________________________________________________________________

Order/Purchase date: ____________________ By: _________________ P.O. # _______________

Donor acknowledgement: _________________________ Notification: ______________________