William Mason Book Donation Club

Name of Donor(s): _________________________________________________________

Grade/Teacher: ____________________________________________________________

Home phone number: _________________________       Total number of books donated _____

Would you like a bookplate to be attached to the book to acknowledge your donation?

Yes ______        No _____

If Yes, please specify the text [max. 6 lines, with 15 characters (including spaces) per line]:

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

Type of donation

1) Monetary:

    Total donation ($20 per book):  ___________

    Form of Payment:

____ cash             ____ check made out to “William Mason Home & School”

    Please indicate whether you will be picking out a book from Mrs. Vogel’s box of new books in the library:

    ____  Yes (Take completed form and payment directly to Mrs. Vogel in the Media Center)

    ____  No  (Send completed form and payment to “WM Book Donation Club c/o L. Cornfield”)

2) Ordered from the Amazon.com wish list:

            Title _____________________________________________________________

            __________________________________________________________________

Please indicate the following:

 ____ The book will be delivered directly to the school (Send in completed form to “WM Book Donation Club c/o L. Cornfield”)

 ____ The book is being shipped to me and I will bring it in to school. (Bring book and completed form to the library)