Worcester Public Library

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Foundation Donation Form

Please print and mail this form with your donation to:

Foundation Executive Director
Worcester Public Library Foundation
3 Salem Square
Worcester, MA 01608

My/Our donation to the Library is $____________________________

Name: ____________________________________________________

Address: _____________________________________________________

City:_______________State: ________ Zip Code: ___________

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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