Friends of Salem Free Public Library Membership and/or Donation Form
(Remember, membership dues may be deductable from your federal income tax)
Name ____________________________________________________________________
Address___________________________________________________________________
Phone Number__________________________Email__________________________________
Annual Membership Dues (check one)
Benefactor ($100) Patron ($75) Donor ($50) Family ($20) Individual ($10) Senior ($5)
I am willing to help with programs, events, or the used book sale.
I am unable to help; however I will support the Friends through the enclosed membership dues.
I do not wish to join at this time, but please accept my donation of $____.
Make check payable to: Friends of the Salem Library
& Mail to:
Mary Cikatz, 29 Corrina Lane, Salem CT 06420
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