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Taft Elementary Library Book
Donation Form
Information provided on this
form is used to make the bookplates, please print clearly.
Book donated by: ________________________________________________________
Contact Information:
Phone Number: ( ) _____ -
_________ email:
_______________________
Student’s name: _________________________________________________________
Teacher’s name: _______________________________________ Grade:
__________
Title of book to be donated: _______________________________________________
If the title you’ve selected is not
available
____ please have the
librarian select an alternate title
____ please contact me
to make a new selection
Price of book: ________________ (make checks payable to Uxbridge Elementary
PTO)
Book donation is in recognition of:
____ Birthday – Date you want printed on the book plate ___
/ ___ / ______
____ Teacher Recognition - Teacher to be honored: _________________________
____ 4th Grade Move-up – month/year graduating ___ / ______
____ Other – please specify:____________________________________________
Your special message to be printed on the Bookplate (Limited to 50 Characters)
Message: ___________________________________________________________
Special Considerations (please indicate your preferences by circling yes or
no):
Yes / No - My child’s picture may be taken and posted on the Donate-a-Book
Bulletin Board
Yes / No - My child’s name may be used in the Taft Tiger Tales
____ Other – please specify:____________________________________________
We will gratefully accept donations for birthdays past or birthdays that will
occur during our summer recess.
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