HONOR WITH BOOKS
WESTERN ILLINOIS UNIVERSITY
University Libraries
I would like to make a tax deductible gift of
$________ for ______ books.
In Memory of: ______________________________________________
(please type or print as you want to appear on bookplate)
In Honor of: ________________________________________________
(please type or print as you want to appear on bookplate)
Address of honoree:
Subject of book: ___________________________________________
(i.e., music, history, economics, etc.)
Name of donor: ____________________________________________
(please type or print as you want to appear on bookplate)
Address of donor:
***My check ($50 per book) for $___________ is enclosed
(made payable to the WIU Foundation)
***I wish to charge the amount of my donation to my
credit card:
____ Visa
____ MasterCard
Number: ______________________
Expiration date: ______________
Signature: __________________________________________________
Return to: Lora Adcock, Western Illinois University,
University Libraries, 1 University Circle,
Macomb IL 61455