J. Robert Jamerson Memorial Library
Gifts and Donations
9.2 Gift Book Program
I/We would like to contribute $_________ for book(s) to be placed in the Library as a
Memorial for: _________________________________, or
In Honor of: _________________________________.
The subject matter I/we prefer for this book is (please specify if you have a preference)_________________________________.
Donor information
Name of donor: _________________________________
Address of donor:_________________________________
Do you wish to be notified when your donation is available for circulation? ____
Do you wish to have a gift plate added to the book purchased with your donation? ____
Signature _________________________________
Date ______
Please make checks payable to the J. Robert Jamerson Memorial Library.
Please return this form to:
J. Robert Jamerson Memorial Library
157 Main Street, P.O. Box 789
Appomattox, Virginia 24522
For Office Use Only
Request received on ______ (date) by _________ (staff initials)
Title(s) selected _________________________________
Acknowledgement sent _________
Book plate(s) added _________
Reserved for donor _________