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.
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.
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