Gift In Kind Donation Form

"*" indicates required fields

Date*

Name

First Last

Organization / Affiliate

Donated Items (Brief Description)*

Dollar Value Estimate

How would you like to be acknowledged for this gift?*

Email acknowledgement only

Mail acknowledgement only

Both mailed and emailed acknowledgement

No thank you, I do not want an acknowledgement

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Notes (For Staff Use Only)