In-Kind Donation Form

The following form should be submitted when making or accepting an in-kind donation to SourcePoint. Please fill out all applicable fields. If you have questions, contact the development office.

Donor Name*
Primary Contact
First Last
Phone*
Email*
Address
Street Address City State ZIP Code
Item Information:
Item
Item Description
Estimated Dollar Value*
Please select one:
- We will send or deliver the item to SourcePoint.
- Please contact me to arrange pick-up of the item(s).
Electronic Signature (Please Type Your Full Name)*
AGREEMENT: By submitting this electronic signature, it has the same validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding. By signing above, I accept the conditions of this agreement.
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In-Kind Donation Form

Item Information:

For office use only

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