Memorial/Honorarium Request Form

Fill out the form below to request a Memorial/Honorarium. Once submitted, your request will be reviewed, and library staff will be in contact.

Name of deceased OR person to be honored

Donor name(s)

Organization Name (if applicable)

Bill to: Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Phone

FAMILY MEMBER OR PERSON TO RECEIVE NOTICE OF MEMORIAL

Name

Address

City/Town

State/Province

ZIP/Postal Code

(In most cases, only one person is notified - $.50 per each additional notification requested)

Average price of adult books - $20.00 & Up
Average price of children's books - $15.00 & Up
Average price of large print books - $30.00 & Up
Average price of DVD/CD - $20.00 & Up

Specific subject area

Do not guarantee that books on a certain subject area can be obtained but we will try. Do not guarantee how long a book will remain in collection; may be weeded after 3 years if not circulating.

Recommended areas of purchase: Best sellers, fiction, children's fiction & non-fiction, large print, DVDs, CDs

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