To submit a donation by mail, print this page, complete your details and preferred charitable level, then mail the form and your check to The Pilcrow Foundation, 343 E. Washington Avenue, Cottage Grove, OR 97424
Title: _________ Name: _____________________________________________________
Street/P.O. Box: ___________________________________________________________
City, State, Zip: ___________________________________________________________
Email: ___________________________________________________________________
To support the work of The Pilcrow Foundation select your preferred method of giving:
___ I enclose my contribution of:
___$10 ___ $25 ___$50 ___$100 ___$150 ___$200 ___$250 ___$300 ___Other $ _______
___ I would like to be a Named Sponsor of The Pilcrow Foundation. Select the number of libraries you would like to support:
___$800 (1 library) ___$1,600 (2 libraries) ___$2,400 (3 libraries) ___Other $ ______
As a Named Sponsor, I would like the following name(s) inscribed on the bookplates:
___In Honor of ___In Memory of ___To Celebrate ___Name Only
____________________________________________________________________________
Please use my contribution in the following state(s) _______________-OR- ___Where Needed