Please print and fill out the following form and mail in with your check to the James Prendergast Library Association.

James Prendergast Library Association
509 Cherry Street
Jamestown, NY 14701

A gift to...
Remember a loved one
Honor a special friend
Commemorate a birth, marriage, anniversary or other special event
Send a unique thank you
A donation to the annual fund.

A gift to the James Prendergast Library is a special way to honor someone special.

It is also a way to help the James Prendergast Library buy books and other library materials which are
lasting gifts for everyone.

Your contribution will be used entirely for the purchase of books or other library materials. 
An acknowledgement card, with no mention of amount, will be sent to whomever you wish.

Also, for every twenty-five dollars contributed, you may have a nameplate bearing an appropriate
inscription placed in a new item.

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Enclosed is my tax-deductible contribution of $__________

(Please make checks payable to James Prendergast Library Association)

[   ]  My gift is in memory of:

[   ]  My gift is in honor of:
           
            On this special occasion:

            Birth__________  Birthday_________  Anniversary__________ 

            Promotion__________  Graduation__________  Other (Specify)__________

            (Note:  This is how the nameplate will be inscribed for each $25 donated)

Please send an acknowledgement card to:

At this address:

[   ]  Use gift donation where needed

My name and address: