Longview Public Library
Gifts and Memorials Program Donation Form

Donor Information

Name

Organization

Address, City, State, Zip Code

Home Phone

Work Phone

Date

Signature

Gift/Memorial Information

Individual /Group Being Recognized/Memorialized

   In Memory Of                     In Honor Of

   Special Event_______________________

   Program___________________________

Special Instructions

Item Donated and Estimated Cost

Donation Amount

Notification Information (Please notify the following person(s)/group(s) on my behalf)

Name

Relationship to Person/Group Being Recognized/Memorialized

Address, City, State, Zip Code  

Name

Relationship to Person/Group Being Recognized/Memorialized

Address, City, State, Zip Code