Please print this form and bring it in to the library or mail it in with your donation.

The Ligonier Valley Library Association
120 West Main Street, Ligonier, Pennsylvania 15658  ~  (724) 238-6451

Enclosed is my contribution in the amount of $ _____________ for:

Diamond Club    Benefactor           Patron Supporter Family Individual

$1,000 and above $500 to $999 $250 to $499 $100 to $249 $35 to $99 $15 to $34

Other $ __________________

If you wish to remain anonymous, please check here.  ____

Name ______________________________________________________________

Address ____________________________________________________________

City & State ______________________________________________ Zip ________

Phone _________________________

Ours is a free public library without charge for its regular services. Accordingly, we must look for voluntary contributions for a substantial portion of the resources needed to provide high quality library services to the community. Contributions are considered to be charitable donations for Federal income tax purposes under Section 170 of the Code.

Please make checks payable to THE LIGONIER VALLEY LIBRARY.