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Donation Form

Belleville Public Library and John M. Parrott Art Gallery Donation Form

MY DONATION SHOULD BE DIRECTED TO

BELLEVILLE PUBLIC LIBRARY

JOHN M. PARROTT ART GALLERY

DONATION AMOUNT:

MY DONATION IS IN SUPPORT OF (NAME OF CAMPAIGN IF DESIRED)

DONOR'S NAME:

MAILING ADDRESS:

PHONE:

EMAIL ADDRESS:

DATE:

SIGNATURE:

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