Mural Wall Form

Mural Wall Donation Form

Your contribution is made with the understanding that the Park City Library has complete discretion and control over the use of all donated funds to assure their use for the intended exempt purposes. All funds received for the tile wall go directly to the library. A donation of $150 is needed to receive one named tile. An additional tile will be added for each additional $150 donated. If more than one tile is purchased, they will be located next to each other. A family may purchase up to four tiles. A specific location for your tile on the tile wall cannot be selected. Please fill out one form for each tile wall square.

Name*
First Last
Phone*
Email*
Donor's Name (this is how your name(s) will be listed on the donor list on the Library’s website)*
Tile Wording*
List the wording for recognition on the donor wall on the two lines below. Inscriptions can be in commemoration of yourself or any person(s) and can be listed with special designation, such as “dedication” or “in honor of.” Each tile may contain up to two lines of text with approximately 20 characters allowed per line including punctuation and spaces. Names will be left-justified and an ampersand (&) will be used in place of the word “and.” The Library reserves the right to final a pproval of all inscriptions. Example: Line 1: Thomas, Jason, Maya, Line 2: Jen & Nan Sutherland
Line 2
- I am interested in supporting the Library with a larger gift. Please contact me with additional opportunites.
- Check here if DONOR'S NAME should NOT be used in publicity recognizing this gift.
Gifts to libraries may be deductible for income tax purposes as provided by law. A copy of the Library’s 501(c)3 determination letter from the IRS is available upon request. The Library reserves the right of final approval on all plaques and inscriptions.
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