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Book Dedication Request Form

Payment may be made through Paypal below, or at any library branch with a VISA card,
Mastercard, personal check, or cash by using the printable form found here: (PDF).
 
                           Name of the individual to be honored; please indicate if "in memory of.":
                                   
                           Title/ Subject Area: (Choose a title or general subject area in the GCPL collection):
                                   
                           Mail the dedication card to :
                           Recipient #1
                           Name :(Mr. or Ms.)
                                   
                           Address :
                                   
                           City/State/Zip :
                                   
        Click here to add another Book Dedication recipient. Each $25 donation is eligible for a book dedication request.
 
                           Name of the individual to be honored; please indicate if "in memory of.":
                                   
                           Title/ Subject Area: (Choose a title or general subject area in the GCPL collection):
                                   
                           Mail the dedication card to :
                           Recipient #2
                           Name :(Mr. or Ms.)
                                   
                           Address :
                                   
                           City/State/Zip :
                                   
        Click here to add another Book Dedication recipient. Each $25 donation is eligible for a book dedication request.
 
                           Name of the individual to be honored; please indicate if "in memory of.":
                                   
                           Title/ Subject Area: (Choose a title or general subject area in the GCPL collection):
                                   
                           Mail the dedication card to :
                           Recipient #3
                           Name :(Mr. or Ms.)
                                   
                           Address :
                                   
                           City/State/Zip :
                                   
        Click here to add another Book Dedication recipient. Each $25 donation is eligible for a book dedication request.
 
                           Name of the individual to be honored; please indicate if "in memory of.":
                                   
                           Title/ Subject Area: (Choose a title or general subject area in the GCPL collection):
                                   
                           Mail the dedication card to :
                           Recipient #4
                           Name :(Mr. or Ms.)
                                   
                           Address :
                                   
                           City/State/Zip :
                                   
   
Name of gift giver :(Mr. or Ms.)
Address :
City/State/Zip :
Name of Paypal account holder (if different) :
Email of gift giver (giver will receive a confirmation email) :
Re-Enter email :
May we add your name, address, and email to our
events mailing list? :
Yes No
Donor contact information will only be used by the library.
 
GCPL is a 501 (C) (3) nonprofit organization. Your gift is tax deductible to the extent allowed by law.
 
Click Submit to pay with PayPal
 
For more information on how to support your library click here, call AskGCPL (770)-978-5154, or email libraryhelpline@gwinnettpl.org