Memorials Request

You can honor a special occasion or memorialize a loved one with a gift to the library. Use the online form below to make an online donation, or download a PDF version of the form to complete and return to one of our libraries.

Date

In Memory Of

Name of Person you would like the library to notify

Address

City/Town

State/Province

ZIP/Postal Code

Donor's Name

First

Last

Donor's Address

Address

City/Town

State/Province

ZIP/Postal Code

Interests of Person to be memorialized

Amount of Gift

While always appreciative of gifts, the Chemung County Library District reserves the right to determine book selection in accordance with the Library District’s Materials Selection Policy. The following list reflects average book costs. Adult Fiction $25 Title of Adult Nonfiction $30 Book Juvenile Fiction $20 Selected Juvenile Nonfiction $25 Donations of $20 or under, not intended for juvenile fiction, will be placed in the Library’s memorial fund.