Memorial Gift

 

Name of Honoree______________________________

Year of Death__________

Donor______________________________

Phone__________

Address______________________________

               ______________________________

 

Title or Type of Book______________________________

 

Dedication____________________________________________________________________________________________________________________________________

Amount of Gift__________

Family Member to Notify of Gift______________________________

Address______________________________

               ______________________________

Please mail or drop off at the Canton Free Library: P.O. Box 150, Canton, NY 13617.