InKind Donation Form

Inkind Donation Form
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Description of Goods*
Estimated Value of Goods*
Would you like your gift to be designated to a specific program?*
I wish my gift to be designated to:
Please explain your designation.
Donation Pick-Up/Delivery*
- I will deliver my donation, please contact me with details.
- Please pick up at the address listed above.
- Please pick up my donation at an alternative address.
My donation will be ready on:*
Date Format: MM slash DD slash YYYY
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
When Hiawatha Homes recognizes donors, would you like your name to be published?
- Yes
- No, please do not publish my name
How would you like to be listed?
I/we would like my/our gift to pay tribute to someone special. Please accept this gift:
- In honor of
- In memory of
In honor of:
In celebration of:
In memory of:
Please send acknowledgement of the above tribute to:
(Notification sent immediately. The gift amount is not indicated.)
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Thank You
We appreciate your generosity!
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