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2. Name
3. Email Address
5. Address
7. City
8. State
9. Zip Code
11. Phone Number
13. Is this a renewal membership?
    -- Select One --YesNo
15. Annual Membership Selection
    -- Select One --Champion ($1000)Advocate ($100)Benefactor ($50)Family ($20)Individual ($10)Student ($5)
17. Additional Options

    1. Please contact me about a special gift to the Library Endowment (i.e. a bequest)
    2. I would like to submit a matching gift form from an employer/organization
    3. I would like my gift to be anonymous
    4. I have enclosed a separate gift in honor/memory of someone
19. Separate gift of:
20. In honor/memory of:
22. Notification of Donation

    1. Please inform the following individual/family of my donation
24. Name
25. Address
27. Please submit this form and bring or mail cash or check donation to: Friends of the Zephyrhills Public Library, Inc., c/o Zephyrhills Public Library, 5347 8th Street, Zephyrhills FL 33542. Donations are tax-deductible as allowed by law. The Friends of the Zephyrhills Public Library, Inc., is an approved non-profit organization under IRS Chapter 501(c)3. EIN 83-208378.
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29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

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