Please print out this form and mail to the address below. Thank you!

Yes, Sign me up!
I want to be a Friend of the Portsmouth Public Library

Name(s) (please print)__________________________________________________

Address_____________________________________________________________

City____________________________State_____________Zip_________________

Phone Number________________Email (optional)___________________________

Membership Levels (Please check)
Individual $10                                            Family $20

Bookworm $25 +                                      Literary Lion $50 +
   Name in one issue of newsletter                      Name in each issue of newsletter

Collector $150 +
Literary Lion benefits plus Book in your name donated to the Library with bookplate

Curator $250 +
Collector benefits plus Your name on plaque in Library

Patron $500 +
Curator benefits plus Advance invitations to Special Events

Contribution to the Churchland Library Furnishings Fund $______________
(Amount will be added to membership amount to assign Membership Level for the year)

I will notify my Corporation to send matching funds.

Donation $_________________________________

Total Contribution $___________ . All contributions are tax deductible.
Make checks payable to FOPPL

Would you like to participate in any of the following Friends activities?
Membership Development                               Newsletter
Book Sales                                                       Advocacy
Other _______________________________________
                 Describe area of interest
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Send this form with payment to:

                                                                      FOPPL
                                                                      P.O. Box 1296
                                                                      Portsmouth, VA 23705

                                                                  Thank you for your support!
                                                                                           
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