You are on page 1of 1

In-Kind Donation Form

Contact First Name: ___________________________

Contact Last Name: __________________________

Company/Organization: _____________________________________________________________________
How would you like to appear in printed materials?
Address: ______________________________________________________________________________
City: _______________________________

State: ___________________ Zip Code: _____________________

Phone Number: __________________________ E-mail Address: ____________________________________


EdgeAlliance EIN Number: 36-3846410
Description of Donation (please be specific):
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Estimated Value of the Donation: _____________________________________________________________
Signature: ________________________________________________

Date: ____________________________

If you have any questions or comments regarding your in-kind donation, please contact
Joey Wasserman, Manager of Community & Special Events, at (773) 359-0122 or
jwasserman@edgealliance.org
EdgeAlliance
c/o Joey Wasserman
212 East Ohio Street, Suite 500
Chicago, IL 60611
Phone: (773) 359-0122
Fax: (773) 935-4662
www.edgealliance.org
Thank you for your generosity!

OFFICE USE ONLY:


RECEIVED BY: ____________________________________________ DATE RECEIVED: ____________________

You might also like