Book Dedication

This book is being gifted (please check one):

In memory of

In celebration of

In honor of

Name of person being recognized on the bookplate:

Please include "Gifted By [My Name]" on the bookplate:

Yes

No

How should we write your name on the bookplate?

Your Name

First Name

Last Name

Your Address

City/Town

State/Province

ZIP/Postal Code

Preferred Method of Contact:

Phone

Email

Phone Number

Email Address

Is there anything else you'd like us to know about your book dedication?

I want to donate:

$15 (for a children"s book)

$20 (for a teen or adult book)

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