Memorial & Honor Gift Form

You may print this form

Memorial & Honor Gift Form

I (We) give/pledge to the Brighton Memorial Library the total sum of:

Donor Name
Donor Address
City		State	Zip
Phone
$	amount of gift
Name(s) of Honoree(s):


Who to notify that donation was made

Name(s)

Address(es)


Credit Card #
Name as it appears on Card
Exp. Date

Make checks payable to:

Brighton Memorial Library Gift Fund

2300 Elmwood Avenue

Rochester, NY 14618

All gifts are tax deductible as permitted by law.