In offering to donate the item(s) described below:

I confirm that I am the owner or have the full right of authority to donate the item(s) to
the Library.

I agree that that the items will be assessed according to the Library’s Collection
Donations Policy located at: http://library.victoria.ac.nz/libraryv2/collections/collection-policy/collection-development-and-management and that the
Library, unless I specify otherwise, will manage the use, location, retention or
disposal of the donated resource/s.
Donor Name:
Anonymous donor: 
Address:
Phone
Email:
Description of the item(s) being donated:
Donor Signature:
Accepted by (Library Staff name):
For Library use:

Date added to collection

Location

Catalogue note

Book Plate
Date: