New Memorial/Honor Book Donation Form

Memorial / Honor Donation Form

If you would like to make a book donation in honor or memory of a loved one, please fill out this form. Please use this form only if you are placing a donation to be paid with Square, our payment vendor. For cash or check payments, please mail to Greensburg Decatur County Public Library, 1110 E. Main St. Greensburg, IN 47240 or contact the library directly 812-663-2826.

Date of Donation:

MonthDayYear

This request is a:

Donation in Memory / Honor of:

First NameLast Name

Information about Donor.

Click here if you do not want a card sent to your address for this donation.

Donor Name

First NameLast Name

Donor Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Donor Phone

Area CodePhone Number

Donor Email Address:

Information about family to be notified.

Click here if you do not want a card sent to the family.

Full Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

More family members? Add more names and addresses in this box:

Information about the Donation

If you do not wish to use Square for your donation, please contact the library directly to make your donation.

Suggested Donation Amounts:

Hardback Book: $25
Children's Picture Book: $20
Audiobook: $45
DVD: $20
Local History Material: $25
Programming / Special Projects: Any

Topic or Subject of Interest:

Please list the type of item you would like added to the collection (eg. Hardback Book, Children's Picture Book, etc.):

Payment

USDDonation Amount

Credit Card

Enter the message as it's shown

Payment*

Credit Card

Payment