Library Foundation Contributor

INDIVIDUAL

CORPORATE

Founder   (above $10,000)

Founder  (above $10,000)

Visionary  ($1,000 to $9,999)

Visionary  ($1,000 to $9,999)

Innovator  ($500 to $999)

Innovator  ($500 to $999)

Builder     ($20 to $499)

Builder  ($20 to $499)

Name_____________________________________

Address____________________________________

City___________________State_______Zip_________

Telephone__________________________________

Restricted:    YES     NO              Library expansion___

                                                          General____

 I would like more information about planned giving:   YES       NO

 Enclosed is my gift of $___________

__________Memorial

__________Birthday

____________Anniversary

____________Retirement

_________Other

Dickinson Area Public Library Foundation

Is a Non-Profit organization

Please return this form with your contribution.

All contributions are tax-deductible.

 Thank you for your support.

COMMENTS:___________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

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Dickinson Area Public Library ~ 139 Third Street West
Dickinson, North Dakota, USA 58601 
Phone: (701) 456-7700 Toll Free 800-422-0541 ~ Fax (701) 456-7700