Deed of Gift
|
Agreement of Donation
|
|||||||||||
|
to the
|
|||||||||||
|
PCA
HISTORICAL CENTER
|
|||||||||||
|
12330 Conway Road
|
St. Louis, MO, 63141 |
(314) 469-9077
|
|||||||||
| The PCA Historical Center has received from | |||||||||||
| Name___________________________________________________ | |||||||||||
| Street___________________________________________________ | |||||||||||
| City_____________________State___________Zip Code_________ | |||||||||||
| Phone_______________________E-mail_______________________ | |||||||||||
| the following collection: | |||||||||||
| I understand and agree that I am giving this collection to the PCA Historical Center as an unrestricted gift and relinquish any rights which I may possess to the contents, unless limiting conditions are specifically stated as follows: | |||||||||||
| I understand and agree that access to these materials will be granted to users subject to the rules of the PCA Historical Center, unless special conditions are specifically stated below: | |||||||||||
| I understand and agree that materials that are not retained by the PCA Historical Center will be disposed of according to the policies and procedures of the Center unless other arrangements are specified as follows: | |||||||||||
| _________________________________________________________________________________ | |||||||||||
| DONOR SIGNATURE | DATE | ||||||||||
| _________________________________________________________________________________ | |||||||||||
| PCA HISTORICAL CENTER REPRESENTATIVE | DATE | ||||||||||