Please print and mail this form with your donation to:

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

My/Our donation to the Library is $_________________

My Check Made payable to the Worcester Public Library Foundation is enclosed.

Please charge my donation to: Visa / Mastercard.

Card # ___________________________________

Expires date: ______________________________

Signature:_________________________________

 

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.