Honor with Books: Gift Form

Yes! I want to honor the person or persons named below by making a tax-deductible gift to Washington University Libraries in the following amount:

__ $50 (for 1 book & a bookplate)

__ $100 (for 2 new books & bookplates, plus Century Club membership)

__ $1,000 (for 20 new books & bookplates, plus Eliot Society membership)

__ Other amount $_____

Donor Information

Name ________________________________________________________________________________

Street address ______________________________________________________________________

City, State, Zip Code _______________________________________________________________

Phone Number _____________________ Email Address (Optional)_________________________

Company Match

__ My employer will match this gift.

Company name _____________________________________________
(Please enclose your company's matching gift form.)

Payment method

__ My check for $_____ is enclosed.

Make check out to Washington University; write "For University Libraries" on the memo line.

__ Charge my gift of $_______ to:

__ MasterCard   __ Visa   __ American Express   __ Discover

Card Number ____________________________

Expiration Date ________________________

Your name, as it appears on the card _________________________________________________

Your signature _______________________________________________________________________

Bookplate Information

Please indicate what information you wish to appear on the bookplate:

Choose one:    __ In honor of    __ In memory of

_____________________________________________________________________________________
Print the name(s) of person(s) honored

_____________________________________________________________________________________
Gift Of: Print your name here if you want it on the bookplate.

Notification (optional)

If you want the honored person(s) or their family to be notified of this gift, please provide:

Name of Person to be Notified _______________________________________________________

Street Address ______________________________________________________________________

City, State, Zip Code _______________________________________________________________

Print out, fill out, and mail this response form and your check to:

Washington University Libraries
Honor with Books
Campus Box 1210
One Brookings Drive
St. Louis, Missouri 63130-4899

_____ Send me information about creating a named endowment fund for library books.

_____ Send me information about including University Libraries in my will.

For more information, contact the Director of Development for University Libraries, Daniel Miller, at 314-935-7128 or email him at Daniel_Miller@wustl.edu.

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