Name:  
Address: 
City  State  Zip 
Phone:         Fax:
E-Mail:

Person being honored / remembered
 

Check one:
In Memory of
Birthday
Anniversary
Thank You
Wedding
Birth
Graduation
Holidays

Other:

Person to be notified
Address
City State Zip

Amount Enclosed:

List interests of the person being honored or memorialized:



Costs:
Children's Book .............$ 25.00
Adult Book Range .........$ 30.00 to $ 50.00




Make yur checks out the the Conyers-Rockdale Library Books Honor People
Program or CRL-BHP. Please mail the form with payment to:

Nancy Guinn Library
864 Green Street
Conyers, GA 30012
Attn: CRL-BHP