Please print
and mail this form with your donation to:
Lucy B. Gagnone, Head Librarian, Worcester
Public Library, 3 Salem Square
Worcester, MA 01608
My/Our donation to the Library is $__________________(average
book price: $30)
Please make your check payable to the Worcester
Public Library.
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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