Alsea Community Library Legacy Fund Contribution Form

The IRS has determined that the Foundation qualifies as an exempt organization under IRS Section 501(c)(3).  Accordingly, gifts to the Foundation are deductible for federal income tax purposes.
If you prefer, you can use  PayPal with a Credit or Debit Card Option
Otherwise, please print (Ctrl+P) and fill in the form below. 
This is my gift to help fund the Alsea Community Library Legacy Fund

__$1000  __$500    __$200    __$100    __$50    __ $25    Other $_____

If you prefer to use a check instead of cash, please make checks payable to:
The Library Foundation

Name _____________________________________________________

Address ___________________________________________________

City, State, and Zip ___________________________________________

Phone Number ____________________

E-mail ___________________________

If you prefer to use a credit card instead of PayPal’s Credit or Debit option, please fill out the following information:

Credit Card number _________________________________________

Expiration Date:________________  3-digit code on the back _________

Your Signature ______________________________________________

Please mail your donation to:
Corvallis-Benton County Public Library Foundation
645 NW Monroe Ave
Corvallis OR  97330

___ (optional) This gift is ___ in honor or ___ in memory of:

Name ______________________________________________

Please notify _____________________________ of this gift.

Address _______________________________________

City, State, and Zip _______________________________

___ I prefer to receive acknowledgement/tax receipt via e-mail

___ I would like to receive the “Check It Out” newsletter via e-mail

___ I do not want public acknowledgement for my donation

We appreciate your generosity!