Date __ __ __ Initials ____ __ _
CANNON COUNTY LIBRARY SYSTEM DONATION
$__________ Memorial $__________ Gift
Donation for _____Adams Memorial _____Auburntown _____Genealogy
In Memory of ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ _________
Name as it will appear on book plate.
Mailing Address __________________________________________________________
Address where notice of donation is to be sent.
____________________________________________________________
____________________________________________________________
Name of Donor (s) ____________________________________________________________
Name (s) as they will be recorded on book plaque.
Address & telephone ____________________________________________________________
Number of donor (s)
____________________________________________________________
____________________________________________________________
____________________________________________________________
Title selection will be at the discretion of the Director following the collection development plan.
A bookplate will be placed in the purchased book stating the name of both the honored and donor.A card will be sent as notification to either the funeral home or person designated by the donor(s). Except in rare instances, we do not accept pre-purchased books by the donor for memorial gifts. This form constitutes the entire understanding of the agreement
May we mention your gift in press releases? Yes _____ No _____
Memorial Card Sent _______Thank You Sent ___________
Items (s) Purchased: