In-Kind Contributions Form (Safe Place for Youth, a Project of Community Partners)

This form is for in-kind donations with a value of $500 of less. If your donation is of greater value, please email the details of your in-kind donation to codym@safeplaceforyouth.org .

Project Information

Form completed by

Please send a letter to the individual/organization below acknowledging receipt of their in-kind contribution to SPY:

Name and Address of Donor (Person, company or organization making the gift):

First Name

Last Name

Title

Organization

Address Line 1

Address Line 2

City

State

Postal Code

How do you want us to deliver the acknowledgement letter?

EmailMail

Description of Donated Item:

Date of Contribution

Type of Item (What is it?)

Approximate Value (for Community Partners’ use only – acknowledgement will not reflect value; donor establishes value for tax purposes)

This form is for in-kind donations with a value of $500 of less. If your donation is of greater value, please email the details of your in-kind donation to sarahb@safeplaceforyouth.org.

In-Kind Donation Type (What kind of donation is this?)

Were any goods or services provided in exchange for this contribution?

YesNo

If yes, describe in detail including an estimate of value:

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