Make A Donation (DRAFT)

This is for test purposes only.

Online Donation In Honor or Memory Of

I am making a donation:(Required)

in memory of a loved one who has passed

in honor of an individual, group, or organization

I would like for my donation to be:(Required)

used to purchase books or audiovisual items for the library's collection

a monetary gift to support the library

Name of person for whom memorial is being made:(Required)

Name of the person, group, or business I'd like to honor:(Required)

Name of person(s) making the donation:(Required)

Email:(Required)

Phone:

Address:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Suggestion for subject or genre of books or audiovisual items:

Plaques placed in items will read: In memory of

Would you like to be notified of the title of items selected for the collection?(Required)

Yes

Please send acknowledgement of my donation to:

Acknowledgement card address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

I would like a second acknowledgement of my donation sent to:

Acknowledgement card address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Donation Amount:(Required)

Total:

Credit Card:(Required)

Cardholder Name

Card Details