Memorial Donation Form Memorial Donation Form Honorary and Memorial Donations Donations honor individuals by providing books or other library materials for the use of the Whitehall community. You may honor both living and deceased individuals. Celebrate a significant anniversary, birthday or just to honor someone who is special to you. If requested, we will put a bookplate inside any materials that you donate. This bookplate acknowledges the honoree, and if requested the donor. In addition, we list the materials donated in our library catalog under the person's name as a digital bookplate. You can search our catalog by the person's name to see the donated material. Complete this form, print from your email (you will receive a confirmation) and return with your check to make a donation. Make checks payable to Whitehall Township Public Library and should be marked "Donation". When you are finished, please send or bring this form to us at: Whitehall Township Public Library 3700 Mechanicsville Road Whitehall, PA 18052 Date:* MM slash DD slash YYYY Donor Information:Name:* First Last Address: Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email: Enter Email Confirm Email Phone:Donation Information:Is this a memorial donation?* Yes No Amount of Donation: Name of Person or event this will honor: What type of material would you like to donate? Book DVD CD Recorded Book Would you like to purchase material on a special subject? If so, please enter the subject: We place gift plates on items. Please provide any special wording you like us to use:Notify:Please notify the following person of my donation: First Last Address: Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Notify:Please notify the following person of my donation: First Last Address: Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Thank you for your donation! We will send a formal acknowledgement. If you have any questions, please contact andrews.c@whitehallpl.org or 610-432-4339 ext: 202. Whitehall Township Public Library is a non-profit organization. Donations are tax deductible. CommentsThis field is for validation purposes and should be left unchanged.
