ReSALE SHOP In-Kind Donation Form

Receipt of In-Kind Charitable Donation
Boost KC
6101 N Chestnut Ave Gladstone, MO 64119
(816) 453-6011
boostkc@boostkc.org
EIN #43-1307672

Boost KC is grateful for your non-monetary donation.
Donors do not receive any goods or services for their contribution.

Establishing a dollar amount of donated items or services is the exclusive
responsibility of the donor and/or an appraiser.

Boost KC reserves the right to determine the appropriate use of your
donation.

Name of Donor (Individual/Corporation)

First NameLast Name

Address (Optional)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email (Provide email address if you want a copy of the completed form)

Do you consent to receiving marketing emails?

Do you consent to being added to our donordatabase?

DONATIONS

Date of Donation (Required)

Date

Donation Items (check all that apply)

List Household Items

Household Donation Value

List Clothing Items

Clothing Donation Value

List Furniture Items

Furniture Donation Value

Misc Items

Misc Items Value

Total Donation(s)

A copy of the completed form will be emailed to you.