I have enclosed $____________ to purchase _______ item(s) at $15 per item for books or music, and $20 per item for movies. Please indicate your choice(s) below and make checks payable to Virginia Public Library.

BOOKS

 

Children's

 

Religion

 

Art

 

Business

 

Literature

 

Science

 

Adult Fiction

 

History

 

Adult Non-Fiction

MOVIES

 

Drama

 

Comedy

 

Animation

MUSIC

 

Classical

 

Jazz

 

Rap/Hip-Hop

 

Country

 

Pop

 

 

 

Folk

 

Rock

 

 

Please print your name, address, and phone number:

___________________________________________________________

___________________________________________________________

___________________________________________________________

Please place the adopted item(s) on hold for me:

_____ Yes _____ No

I wish to have my name included on the Library's published list of donors:

_____ Yes _____ No

** Please print name exactly as you'd like it to appear: _________________________________________________

I wish to have a bookplate placed in the item(s) I adopt:

_____ Yes _____ No

** Bookplate Inscription (please print): _________________________________________________

I wish to receive a charitable tax deduction form for my donation:

_____ Yes _____ No

Virginia Public Library
215 5th Avenue South * Virginia, MN 55792