Memorial and Honor Book Information Form:

 

 

Title of Book: ____________________________________________________________

 

Author of Book: __________________________________________________________

 

Donated by:

            NAME: ___________________________________________________________

                                    (Please print name as it should be worded on bookplate)

 

            ADDRESS: _______________________________________________________

                                _______________________________________________________

 

____ In Memory of

 

____ In Honor of

 

____ Birthday ______ Age _____ Date of Birthday ______________________________

 

Other event (such as retirement) _____________________________________________

Please list event __________________________________________________________

 

NAME of person honored __________________________________________________

 

 

Library:            ARCOLA GRADE SCHOOL _________________________

                        ARCOLA HIGH SCHOOL ___________________________

 

PLEASE LIST BELOW THE NAMES AND ADDRESSES OF THOSE WHO SHOULD BE NOTIFIED OF THE DONATION.

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