Gift In Kind Donation Form printable pdf download

One Commerce Drive

PO Box 10832

Bedford, NH 03110-0832

Toll-free 888.474.9686 (888 GSGWMTN)

F 603.627.4169

GIFT-IN-KIND DONATION FORM

Thank you for supporting the Girl Scouts of the Green and White Mountains with your Gift-In-Kind donation.

Please complete this form below to ensure that you are properly acknowledged for your contribution. If you

have any questions, please contact the Fund Development Department.

Donor or business name:_____________________________________________________________________

Contact (if other than above):_____________________________ Phone:______________________________

Donor or Business Name:_____________________________________________________________________

Fax:__________________________________ Email:_______________________________________________

Contact (if other than above):_____________________________ Phone:______________________________

Address:__________________________________________________________________________________

Fax:__________________________________ Email:_______________________________________________

City:________________________________________________

State:________

Zip:______________

Address:__________________________________________City:_____________________________________

State:___________ Zip:____________

Description of Gift-In-Kind:

Value of gift (as assigned by donor):_____________________________________________________________

Donor signature:______________________________________ Date:________________________________________

The Girl Scouts of the Green and White Mountains is a nonprofit organization under section 501 (c)(3) of the Internal

Revenue code; therefore, your donation may be tax deductible as allowable by law. PLEASE RETAIN A COPY OF THIS

COMPLETED FORM FOR YOUR RECORDS.

Date Gift-In-Kind Received:________________________ GWGWM staff signature:_______________________________

Gift In Kind Donation Form