DONATION FORM

Name: _______________________________

Address: _________________________________

City: ___________________ State: _______ Zip Code: _____________

Phone: _______________ E-mail address: _________________________

Enclosed is a check in the amount of $_____________

payable to: Friends of the Ashland Public Library

All contributions are tax deductible (Federal ID #31-1576133, Oregon registration #15327.)

Please print this form and mail it and your donation to:

Friends of the Ashland Public Library
PO Box 91, Ashland, OR 97520

or put it in the box across from the circulation counter in the library.

THANK YOU!