Donation Receipt Form printable pdf download

Donation Receipt Form

Tax-ID #: 26-1412551

140 Russ Street , Suite S101

Hartford, CT 06106

860.548.9877

860.548.3067 fax

Donation Receipt Form

Thank you for your generosity!

Your contribution will support the non-profit initiatives at Billings Forge Community Works, located in Hartford’s

Frog Hollow neighborhood. We are making an impact on economic revitalization and

community redevelopment, using food and art as the catalysts to social change.

Name: _________________________________________________________________________

First

Last

Address: _______________________________________________________________________

State: ________ Zip Code: ____________ Email: _____________________________________

Phone: _________________________________________

Gift Information

I would like to make a donation(s) of:

$50

$100

$500

$1,000

Other $_______

Please apply my donation towards:

__General

__The Kitchen

__The Garden

__The Farmers’ Market

__The Studio

__The Workshops

I would like to make an in-kind contribution of:

_______________________________________________________________________________

Estimated value: $_______________

Payment Options

My check is enclosed for

Please charge my donation to my credit card:

VISA

MASTERCARD

AMEX

Card Number:_________________________________________Expiry:_________Code:_______

Name on Card: __________________________________________________________________

Signature: __________________________________________________ Date: ______________

Billings Forge Community Works is a 501(c)(3) not-for-profit tax exempt organization.

Donation Receipt Form