In-kind Donation Form

Page 1

IN-KIND DONATION FORM Business Name or First & Last Name of Individual Donor ____________________________________________ Contact Name for Business Listed Above __________________________________________________________ Circle any that apply: a) Alumnus

b) Business/Vendor

c) Current Parent

d) Past Parent

f) Trustee/Former Trustee

Address _______________________________________________________________________________________ City_____________________________________ State _____________________ Zip Code __________________ Email __________________________________________________ Phone_________________________________ How would you like to be recognized in the Journal? _________________________________________________ DONATION INFORMATION Description of Tangible Item/Service (Include restrictions, specific use, dates, etc.) ___________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________

Fair Market Value of the Donation $ _________________ (For tax-deductibility purposes)

PLEASE CHECK ONE □ Donor to mail/deliver item by: ____________________ (date) □ Gift certificate enclosed. □ No tangible gift certificate enclosed; Loyola should create one for the donor. All donated items become the sole property of Loyola School. All proceeds from the Auction benefit Loyola School. Loyola is a 501 (c)3 tax-exempt organization. Tax ID #13-162-4073 (For office use only) Solicitor Information Solicitor Name _____________________________________________________ Phone ____________________________________ Circle any that apply: a) Alumnus b) Current Parent c) Past Parent d) Trustee/Former Trustee □ Gift certificate received □ Item received □ Create certificate □ Procurement # _____________ □ Date Entered/Initials ____________

Send your completed form with gift(s) to: Loyola School • 980 Park Avenue • New York, NY 10028 • Attn: Kate Fiscus • Email: kfiscus@loyola-nyc.org • Office Phone: 646.346.8135 •Fax: 212.879.4864 Donations must be received by TUESDAY, APRIL 2, 2013 in order to be included in print and online materials.

On behalf of the 2013 Auction Committee, thank you for your generous participation!


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