Bartholomew County Library Associates - 2012 Annual Fund Drive Tax Exempt EIN 35-6058892 Please print this form and mail it to: Business Office       Bartholomew County Public Library 536 Fifth Street, Columbus IN   47201
Contact Information: ________________________________________ Name ________________________________________ Address ________________________________________ City, State, Zip Code ________________________________________ Day Telephone ________________________________________ Evening Telephone ________________________________________ email Address	Donations and Designations $5-$24 Dr. Seuss $25-$49 Mark Twain $50-$99 Jane Austen $100-$249 Charles Dickens $250-$499 Dorothy Parker $500 or more William Shakespeare
Payment Options One-time 2011 payment in full A pledge to be paid during 2012 (All pledge payments must be received by December 31, 2012.)	This is a matching gift Company: ____________________________ Please include company form.
Check Information Check Number: ____________ Amount: $____________ Pledge Information (All pledge payments must be received by December 31, 2012.) Amount: $________________
Memorial Gifts Memorial gifts and donations in honor of individuals can be made to Bartholomew County Library Associates. Donations can be designated for the purchase of books, equipment, or other resource materials. Gifts are tax deductible. Persons interested in making a gift to the library, either memorial or non-memorial, can contact Library Administration or call (812) 379-1255.
Volunteer Opportunities Please contact me about: Helping with the Bargain Book Sale Serving on the Bartholomew County Library Associates board of directors