102 The Plains Road P.O. Box 1335 Middleburg, VA 20118-1335 Phone: (540) 687-6542 Fax: (540) 687-8540 Please Print Name: ____________________________________________________________________________ Address:___________________________________________________________________________ City_________________________________________State__________Zip____________________ Country ___________________________________________________________________________ Phone ____________________________________ Email___________________________________ Giving Categories: ___ Ivy Circle $5000 ___ Chairman's Council $2,500.00 ___ Guardian $1,000.00 ___ Sponsor $250.00 ___ Friend $50.00 Donation Method: ___ My check or money order is enclosed. (Make checks payable to National Sporting Library.) ___ Please bill my Visa. ___ Please bill my Mastercard.
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