Fields marked * require an entry.

In-Kind Donation Form

Members are asked to complete the In-Kind Donation form for any donations made to LeanderARW. These include donations such as goods or services and anything other than cash transfers.

Note: Corporate donations and Anonymous donations are not permitted by TEC rules.

In-Kind Donations

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Reason For Donation:

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

No

Occupation - If Retired specify profession, i.e. Retired Nurse

Occupation:*

Company - required for all in-kind donations

Company:*

How do you want your Name Listed for publication?

Published Name:

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country / Location:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*

In-Kind Donations

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