Horsham Township Library Memorial Contribution Form

Thank you for choosing to give a gift to the Horsham Township Library to honor the memory of a friend or loved one. The library will mail a card to the family, informing them of your donation. A memorial book plate will be placed in each book with the name of the honored person and the donor's name. A minimum donation of $25.00 is requested.

Please print this form out, fill in the information, then bring it to the library or mail it with your check made payable to "Horsham Township Library."

I would like to give a gift in memory of:

Your name:
Your mailing address:
Your City, State and Zipcode:
,

The library will send a card acknowledging your gift to someone, such as a family member of the person being memorialized.

To whom would you like the card to be sent?
Their mailing address:
Their City, State and Zipcode:
,

What would you like the bookplate to say?

In memory of:
Given by:

If you wish, please tell us what subjects or types of publications you would like the library to purchase with your memorial gift. (For example: Biography, children's book, classical music recording, large print book, mystery, book about American history, etc.)

Suggestions for the type of item to be purchased:
Amount of your gift:

Horsham Township Library
435 Babylon Road
Horsham, Pennsylvania 19044-1224
Tel: (215) 443-2609    Fax: (215) 443-2697
  © 2004
Horsham Township Library.
All rights reserved.