Gift Intention

Name

Please print your name as it will appear in the donor acknowledgments.

Address

Email

City

State

Zip Code

Telephone

Date (MM-DD-YYYY)

Amount intended

Please print my/our name(s) in the donor list as follows:

I/We prefer to remain anonymous.

Payment schedule - Please indicate your payment preference:

Quarterly (if so, which months):

Yearly (if so, which month):

Payments will be completed by:

Yes, you have my permission to include my name as a supporter in your development and fundraising initiatives.No, I would prefer you not use my name in your development and fundraising initiatives.

Signature:

Checks should be made payable to the Concord Free Public Library Corporation.
For information about gifts of securities, please call the Development Office at (978) 318-3355.