In-Kind Donation Form

Thank You for Your Generous In-Kind Donation

Your donation will support the American Cancer Society through the Agents Against Cancer Tournament Fundraiser. To ensure we accurately represent your contribution in our auction, please complete the form below.

Donor Name

First NameLast Name

Donor Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Donor Email

example@example.com

Donor Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Package Name

Details of Package

Restrictions/Black Out Dates (if applicable) if none please indicate N/A:

Expiration Date (if applicable) if none indicate N/A

Package Value

How would you like the donor name displayed

Please provide the name and contact information (phone number and email) of the person the winner should reach out to in order to redeem this package.

The American Cancer Society gratefully acknowledges the In Kind gift(s) described above. No goods or services were provided by the American Cancer Society in return for the gift(s).

PLEASE NOTE: The American Cancer Society cannot attach a proper dollar value to your gift. Federal tax laws impose certain reporting obligations for charitablecontributions of property other than cash. IRS Form 8283 and its instructions can assist you with your reporting obligations..

Your contribution is tax deductible to the extent allowed by law.

Questions? Please contact Jennifer Davis at jennifer.davis@cancer.org