BUY-A-BOOK CAMPAIGN

Your Information :

First Name: ______________________________________________________

Last Name: _______________________________________________________

Home Address: ___________________________________________________

City: ______________________________________

Zip Code: __________________________________

Home Phone: _______________________________

E-Mail: ____________________________________

Area of Interest :

Fiction   Mystery   Romance   Sci-Fi   Non-Fiction   Reference   Children's Books  
Other : __________________________

Please inscribe the book as shown in the boxes. Maximum 21 characters per line including punctuation and spaces.

Print this application form and mail along with your check for $50.00 to :

    Friends of the South Huntington Library
    Attn: Buy-A-Book Campaign
    145 Pidgeon Hill Road
    Huntington Station, NY 11746