In-Kind Donation Form

Item Information
Name of merchant/donor____________________________________________________________________
How company name should appear in print_____________________________________________________
Signature________________________________________________________________________________
Contact Person___________________________________________________________________________
Address_________________________________________________________________________________
City________________________________________________________ State________ Zip_____________
Phone____________________________________ Fax___________________________________________
E-mail___________________________________________________________________________________
Item Description___________________________________________________________________________
Item Restrictions (expiration dates, etc.)________________________________________________________
Retail Value of Item___________________________________________ Date_________________________
CCFA Information Office Use Only
Solicitor_________________________________________________________________________________
Date item received in office__________________________________________________________________
Date thank you sent to donor_________________________________________________________________
Item use for (auction item, prize, award, etc.)____________________________________________________
Event or program item was used for___________________________________________________________
If used in an auction, how much did the item raise?_______________________________________________
Who purchased the item?___________________________________________________________________
Thank you for supporting our mission through your generous donation!

Please return your completed form to:

CCFA Rocky Mountain Chapter
1777 South Bellaire Street, Suite 230 Denver, CO 80222
PH 303-639-9163 FX 303-639-9166 E-mail rockymountain@ccfa.org
The Rocky Mountain Chapter serves Colorado, Utah and Wyoming