For Staff Use Only:
Thank you sent: ______
Acknowledgement sent: ______
Bookplate: ______
108 East Railroad Street • St. Johns, MI 48879
Phone: 989-224-4702 • Fax: 989-224-1205
Donation Worksheet
Date: _____________________
Staff Initials: _______________
Donor Name: ________________________________________ Phone Number: _________________________
Donor Address: ______________________________________________________________________________________
_______________________________________________________________________________________
Would like to remain anonymous Amount of Gift: $_________________________
Check # _______________________ / Cash
Designation of Gift – Please indicate preference *
Materials – Please indicate the following:
Age Level: Preschool Elementary Teen Adult
Type: Print Materials Audiobooks DVD Specialty Collections (This ‘n That, Garden, Back Packs, etc.)
Subject or genre: _______________________________________________________
Other information: ______________________________________________________
Building Renovation Fund – Used for upcoming library renovations/improvements
Technology – Used for purchases of computer equipment, upgrades and networking
Bookplate Description
In Honor of / In Memory of (circle one): _____________________________________________________________________________
Donor Name on Bookplate (yes or no): _____________________________________________________________________________
Acknowledgement Letter
Send acknowledgement letter to:
Name: _______________________________________________________________________________________________
Address: _______________________________________________________________________________________________
_______________________________________________________________________________________________
*NOTE: All donations are subject to Director approval or that of his/her designee. If donor does not specify a designation,
gifts may be deposited to the General Fund.
