Cape Assist Endless Summer Benefit
In-Kind Donation Form
Contact Name:
*
First Name
Last Name
Donation Made By an Individual? Or Business/organization?
Please Select
Individual
Business/Organization
Phone Number:
*
Please enter a valid phone number.
Email:
*
Confirmation Email
example@example.com
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business/Organization Name:
*
Business/Organization Phone Number:
*
Please enter a valid phone number.
Business/Organization Email:
*
Confirmation Email
example@example.com
Business/Organization Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Donated Item 1:
*
Description of donated item
Donated Item 1 Value:
*
Description of donated item
Add Another Donated Item?
*
Please Select
No
Yes
Donated Item 2:
*
Description of donated item
Donated Item 2 Value:
*
Description of donated item
Add Another Donated Item?
*
Please Select
No
Yes
Donated Item 3:
*
Description of donated item
Donated Item 3 Value:
*
Description of donated item
If there are any requirements/restrictions regarding the donated item(s), please provide information below:
Will Donation Require Pickup?
*
Please Select
No
Yes
Provide any donation pickup information such as preferred times/days for pickup:
Submit
Should be Empty: