ACRL Friends Program Donation Form

friends logo

Name_________________________________________________________________

Address________________________________________________________________

City, State, Zip__________________________________________________________

Phone__________________________________________________________________

E-mail: ________________________________________________________________

Enclosed is my donation of $________________________________________________

Check the Club that corresponds with your donation:
on printout, check box for selection   Patrons ($1,000 and over)
on printout, check box for selection   Sponsors ($500-$999)
on printout, check box for selection   Contributors ($250-$499)
on printout, check box for selection   Associates ($100-$249)
on printout, check box for selection   Friends (Less than $100)
on printout, check box for selection    I am making a gift as an honorary or memorial tribute. If you check this box, please provide the individual's name, indicate if it is a honor or memorial gift, and include an appropriate address if you would like a gift acknowledgment sent to the individual or their family.

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

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Choose the funds you wish to support and how your donation should be allocated
Program Fund Amount

Professional Development Fund

$_______________

Innovative Programming Fund

$_______________

Advocacy Fund

$_______________

Board Strategic Plan Initiative Fund

$_______________

William Moffett Memorial Fund

$_______________

RBMS Scholarship Fund

$_______________

on printout, check box for selection   Check enclosed (Please make checks payable to the American Library Association)
on printout, check box for selection   Am. Ex.          on printout, check box for selection   VISA          on printout, check box for selection   MC

Account number________________________________

Exp. Date_________

Signature______________________________________

Mail your donation to:

The Friends of ACRL
Association of College & Research Libraries
50 E. Huron Street
Chicago, IL 60611-2795

Thank you for becoming a Friend!