GALETON PUBLIC LIBRARY BUILDING FUND
5 PARK LANE
Galeton, PA 16922


Supporters of the new Galeton Public Library are invited to sponsor an 
engraved brick to become a permanent part of the new building's grounds.  

For a donation of $50, the 4" X 8" paving brick will be engraved with the 
name of a contributor, a family member, a beloved camp, or other respectful and 
inspirational words for future generations to read and remember.  


SUPPORTER'S NAME	__________________________________

Address		        __________________________________

			__________________________________

			__________________________________

Phone			__________________________________

Email (optional)	__________________________________


BRICK ENGRAVING 

Please write especially clearly so that there are no mistakes!
Each of the 3 lines may have up to 12 spaces or characters.

Line 1  __   __   __   __   __   __   __   __   __   __   __   __

Line 2  __   __   __   __   __   __   __   __   __   __   __   __

Line 3  __   __   __   __   __   __   __   __   __   __   __   __


Thank you for your generous support of the Galeton Public Library and the future 
of this beautiful community!

Please mail this form with your donation to:

GALETON PUBLIC LIBRARY BUILDING FUND
5 PARK LANE
Galeton, PA 16922
________________________________________________________________

Order Number _______________
Date ______________________