Library Donation Form

Donor’s Name:

Donor’s Address:

Donor’s Phone #:


Donated Items (please list):

Value of Donated Item(s): $_____________

Your signature on this form acknowledges that the donation of the above item(s) is now the property of the Annie P. Ainsworth Memorial Library.  Thereby, the Library reserves the right to determine use and disposition of all donated materials.

Signature of Librarian: ________________                 

 Date: _____________

Donation(s) accepted by:

Signature of Librarian: _____________

Date: ______________

Thank you so much for your donation!

Approved 3/21/17