FRIENDS
OF THE BASTROP PUBLIC LIBRARY PORCELAIN TILE ORDER FORM
Name:___________________________________________________________________
Address:_________________________________________________________________
Telephone Number (s):_______________________________________________________
Each tile order must be placed
on a separate form. Additional forms are available at the library or
this form may be copied. When ordering more than one tile, the total
cost can be paid with one payment. Please attach multiple orders together.
Select a Tile size:
____ 12” x 12”, $1,000.00, quantity _____. ____
8” x 8”, $500.00, quantity _____.
____
4” x 8”, $250.00, quantity _____.
Enclosed is my tax-deductible contribution of $________________.
Return this order
form and payment to:
Friends of
the Bastrop Public Library
P.O. Box 670
Bastrop, TX; 78602
Please make
checks payable to the Friends of the Bastrop Public Library.
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The Friends of the
Bastrop Public Library is a 501(c)(3) nonprofit organization.
All donations are tax deductible as permitted by law.
Please print clearly, in
the spaces provided below, the name you want to appear on your tile.
The only acceptable wording, besides the name of a company, individual(s)
or organization, is “In memory of” or “In honor of”.
You must leave a blank box to indicate a space. Only letters and numbers
can be used.
A 4” X 8” tile has three lines, with 14 spaces per line.
An 8” x 8” tile has six lines, with 14 spaces per line.
A 12” X 12” tile has 12 lines with 14 spaces per line.
4"
x
8" |
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8"
x
8" |
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12"
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THE FRIENDS THANK
YOU FOR SUPPORTING THE BASTROP PUBLIC LIBRARY!