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Brooklyn Public Library - Donation Form

Print, complete, and mail this form with your payment to:
Brooklyn Public Library
Development Department
10 Grand Army Plaza
Brooklyn, NY 11238
 or fax it, with credit card information, to: 718-399-7706
Our phone number is 718-230-2738.

Required

First Name Middle Name Last Name


Address Apt. #


City State Zip


Telephone Email


Donation & Payment Details
$2,500 $1,000 $500 $250 $125
$75 $60 $50 $25 Other              
Single Gift of $              
Recurring Gift: $               per month for                           
Installment Plan: $               to be charged                           

My check, payable to Brooklyn Public Library, is enclosed.

Please charge $____________ to my credit card:
MasterCard  Visa  American Express
 
Credit Card #                                                    Exp.             /             

Signature                                                         
Optional Direct my Donation*
I would like to direct my gift to:                                                      

Matching Gift*
My company,
                                                     
will make a Matching Gift.


Memorial/Tribute Gift
In Memory of:
In Honor of:
Honoree's Name:                                                      
Please send notification of this tribute to:

Full Name
Address
City
State Zip
* To make a selection see online form for options.