Honor with Books Reply Form

Please fill out this form print it and mail or fax it as indicated. You may choose the wording that will appear on your bookplate. Due to space restrictions, we try to limit the text to 25 words. If you have any questions, please call Judith Adams-Volpe , at (716) 645-2756 x228 or send email to adamsj@buffalo.edu

To use your own wording on the bookplates, write it below:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

If you would like to designate a subject area for your book, please indicate:
Art/Architecture
Business/Management
Education
Engineering/Computing
Humanities
Information/Library Science
Law
Medicine/Nursing or see Health Sciences Library Honor with Books
Social Sciences
Sciences
Other:___________________________________________________________

Name: ________________________________________________________________________
UB Class Year:________________________ UB School:_______________________________
Address: _____________________________________________________________________
City: _________________________
State: ________________________
Country: _____________________
Zip Code: ____________________
Phone:________________________________________________
Email:________________________________________________
Credit for this gift should go to (spouses/partners/children, etc.) ____________________________________________________________________________

If the person(s) with whom you are sharing credit is an alumna(us), please indicate UB Class Year
____________________________________________________________________________

Do you work for a company that matches gifts to universities?
Company name________________________________________________________________

Gift Amount (US $):
$100 $150 $250 $500   Other: _________________

Please make checks payable to the "UB Foundation," and write "Honor with Books" in the memo line on your check. Please send your donation and the Reply Form to the following address:

University Libraries
Communication & Development
223 Capen Hall
University at Buffalo
Buffalo, NY 14260-1672
Fax: (716) 645-3710