In-Kind Donation Form

Gift-In-Kind Donation Form
Date

MonthDayYear
Donor Full Name*

First NameLast Name
Business Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Number*
Email Address*
Description of item(s). Please include any restrictions and valid dates, if applicable.*
Value of donation as assessed by donor*
Signature Event gift is for (if applicable)
Academy of Our Lady Mercy, Lauralton Hall is a 501(c)(3) non-profit organization.
Our federal tax identification number is: 06-0653077.

200 High Street Milford, CT 06460 / T: 203-877-2786 / F: 203-876-9760
info@lauraltonhall.org / LauraltonHall.org
Sponsored by the Sisters of Mercy
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Gift-In-Kind Donation Form