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Name and Address:

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Phone: _______________________________________

Email: ________________________________________

I want to help REBUILD NEW ORLEANS PUBLIC LIBRARY with a gift at the following level:

 $500       $1000       $2500       Other $_______________   (Any amount is welcome!)

Method of Payment:

 Check (payable to Friends of New Orleans Public Library)
 VISA
 MasterCard

Credit Card Number: _______________________________________________________

Expiration Date: ___________________________________________________________

Signature (required for credit card payment):

__________________________________________________________________________

Please return the completed form to:

Friends of the New Orleans Public Library
Restoration Fund
219 Loyola Ave.
New Orleans, LA 70112-2044