Scottsdale Public Library Memorial and Honoree Form

Fill in online and print out. Close the window AFTER you have successfully printed the form.

Donor Information
Name:
Street Address:
City, State Zip:
Phone:
Email:
I am not providing Donor Information because I wish to remain anonymous.
Amount of donation: $ ($25 minimum)
Preferred subject for books/materials (optional):

Dedication Information

For honor and memorial donations, a bookplate will be placed inside the book
dedicating it to the person you specify.

In Memory Of (deceased) To Honor (living)
Name:
Relationship of
Donor to Honoree:
Occasion for honor:

Acknowledgment
The library will send an acknowledgement to the Honoree or to the family of the Deceased.
Name:
Address:
Relationship of recipient of
acknowledgment letter to Honoree:

Please print the completed form and pay with cash, check (made payable to City of Scottsdale)
or credit card at your Scottsdale Public Library or mail the form and your check to:

Director of the Scottsdale Public Library - 3839 N. Drinkwater Blvd., Scottsdale, AZ 85251-4467

If you have any questions, call 480.312.2446. Thank you!