KISKI AREA HIGH SCHOOL LIBRARY MEMORIAL FORM

Contributor(s):__________________________________________________________
Contributor(s):__________________________________________________________
In memory of:___________________________________________________________
Amount donated: $____________________
Acknowledgment to be sent to:

Name:_____________________________________
Relationship to deceased:______________________
Address:____________________________________
___________________________________________

Subject preference of book, if any:__________________________________________

(Example: Deceased was an avid hunter)
A memorial bookplate will be attached to the book. The format of the bookplate will be
as follows:

Donated to the library by

(Name of person or organization)
In memory of (name of deceased)
(any additional information requested)
Kiski Area High School Library
(year of donation)

Please indicate any information you would like included on the memorial bookplate:
____________________________________________________________________
____________________________________________________________________
Please make check payable to: Kiski Area High School Activity Fund
Mail to:

Mr. John Swanson, Librarian

Kiski Area High School
200 Poplar Street
Vandergrift, PA 15690