Fillable Donation Drop off Form (Palmer College of Chiropractic)

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Donation Drop off Form (Palmer College of Chiropractic)

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1000 Brady Street, Davenport, IA 52803-5214 | P: 563-884-55893 | library.palmer.edu
Donation Drop off Form
Name: ________________________________________________
Address: ________________________________________________
________________________________________________
Phone: ________________________________________________
Email: ________________________________________________
Notes: (i.e. where items came from, who they belonged to)
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Thank you for supporting the Library!
________________________________________________ _________________________
Donor’s Signature Date
OFFICE USE ONLY
Drop off Location: Circ __________ Special Services __________ Welcome Center
Other __________ Staff Member Initials __________ Contacted Special Services
DISCLAIMER: Once gifts are received, items become the property of the David D. Palmer Health
Sciences Library. If you own the copyright to the materials, the library has permission to digitize unless
otherwise noted. The Library reserves the right to use or dispose of such materials in any manner deemed
appropriate, without any obligation to the person making the donation.
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Donation Drop off Form (Palmer College of Chiropractic)

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Completed 20 August 2020

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