Worcester Free Public Library


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Donation Form

Commemorative Book Donation Form

Please print and mail this form with your donation to: Worcester Public Library Foundation, 3 Salem Square Worcester, MA 01608

My/Our donation to the Library Foundation is $____________(average book price: $30)
Please make your check payable to the Worcester Public Library Foundation.

Name: _____________________________________________________

Address: _____________________________________________________

City:_______________State: ________ Zip Code: ___________

I/We would like this gift to be used for the purchase of books in the following subject area(s): ______________________________________________________

Gifts may be made to the Library in honor or in memory of a person, to celebrate a family event or to mark any special occasion.

This gift is in memory of :___________________________________

This gift is in honor of:__________________________________

on the occasion of_________________________________________

Please notify: __________________________________ of my gift.

Their address: _________________________________________________

City: ___________________State: ____ Zip: ___________

Your contribution is tax-deductible to the extent provided by law

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