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2. Note

   The sign in or create account option above refers to your city account, not your library account. 

4. Donor Name
6. Address
8. City State Zip
10. Phone
12. Email
14. Date
18. 
19. Tile Sizes

    6 x 3 tile	$1,000 + donation
    6 x 6 tile	$5,000 + donation
    12 x 6 tile	$10,000 + donation
    12 x 12 tile	$200,000 + donation

21. Name
22. Desired Tile Size

    1. 6 x 3 tile
    2. 6 x 6 tile
    3. 12 x 6 tile
    4. 12 x 12 tile
26. Amount
28. Payment Type

    1. Check - Payable to Anacortes Public Library Foundation
    2. Credit Card/PayPal
30. Please Mail or Deliver Checks To

    Anacortes Public Library Foundation

    1220 10th St. 

    Anacortes, WA 98221

32. 
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field