Donation/Memorial Form

Please print this page out, fill in the information, and mail your donation to:

J. R. Huffman Public Library
375 Sabine Street
Hemphill, TX 75948

Donor's Name:___________________________________________________

Address:________________________________________________________

City, State, Zip:___________________________________________________

Phone:_________________________________________________________

This donation is for:___General___In Memory Of___In Honor Of

Name of Person
_____________________________________________

Please send me a written thank you card (Y) (N)

May the library acknowledge your name for this memorial in our local paper? (Y) (N)

Please send an acknowledgement card to:

Name
:____________________________________________

Address:__________________________________________

City, State, Zip:_____________________________________

Phone:____________________________________________


Donation Amount:  $______________