Here is my Gift:

  $25    $50    $100    $250    $___________ Other

Please Apply My Gift to:

  Building Fund  Collection (Books, Videos, Tapes

  Children's Programs    Senior's Programs

Other (Please Specify)___________________________________________

Please Make Check Payable to: New Hartford Public Library, or Use Your Credit Card

Visa    Mastercard  Other___________________________________

Card Number:________________________  Exp. Date:_____/_______

Print Name(s) to be Used for Recognition: __________________________________________________________________

This Gift is in Memory Of:                      This Gift is In Honor Of:

_________________________________ _________________________________

Please Send Notification of this Gift to:

Name:_____________________________________________________________

Address:___________________________________________________________

City:__________________________________ State:_______ ZIP:____________

Donor Name:________________________________________________________

Donor Address:______________________________________________________

City:__________________________________ State:_______ ZIP:_____________

  I wish my gift to remain Anonymous.

  I would like to know how to remember the library in my will.

  I would like to know how to make a gift of stock to the library.

  In addition to my gift, a matching gift will be made by my employer.

Company Name:_____________________________________________________

PLEASE ENCLOSE MATCHING GIFT FORM

Signature_________________________________________________

Mail to:
New Hartford Public Library
2 Library Lane
New Hartford, NY 13413-0461