Please print or type the information in the blocks exactly as you would like it to appear on the tile(s). Please note: all two-line names will be placed on a garden tile. Don't forget to leave spaces where needed
Please print out this form and mail with payment to: West Hurley Public Library, 42 Clover St., West Hurley, NY 12491
-Contributions are deductible to the extent allowed by law.-
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