Blair Public Library
Adopt-a-Magazine

I agree to sponsor a subscription to the magazine listed below for the Blair Public Library for one year starting in the next month. The library will use its regular agent for the subscription.  I understand that the most recent issue of this periodical will be placed in a display binder with a note that I adopted it and that all other issues will be available for circulation. I understand the my donation will also be listed in the local newspaper with new book arrivals. I understand all decisions concerning the selection and location of all library materials are the library's responsibility.

_____________________________________      $ _____________         Would you consider renewing your donation again next year?
Magazine Name                                          

Donation Amount

  
           
___________________________   Make checks payable to:
Blair Public Library Foundation
Donation Date          

 
Book Plate Information          

Sponsored by:

_____________________________________________		       I prefer to remain anonymous.

 		          
           
In Honor of:  (optional)

_____________________________________________
 		   In Memoriam of:   (optional)

_____________________________________________

Donor Information

                Name: ______________________________________

Address: ____________________________________

City, State ZIP Code ___________________________

Phone Number _______________________________                                     

 
Office Use:    Sponsorship Start Date: ____________   End Date: _____________
 
               Invoice Amount: ____________   Invoice Date:__________________

               Book Plate: _________________