Fields marked * require an entry.

THE MOUNTAINEERS

2020 IN-KIND CONTRIBUTION FORM

Thank you very much for making an in-kind donation to The Mountaineers 2020 Gala. This form will help us to properly record and acknowledge your generous gift.

If you have any questions regarding this form, please contact:

Tyler Dunning

7700 Sand Point Way NE

Seattle, WA 98115

Phone (206) 521-6026

tylerd@mountaineers.org

This form does not serve as a receipt for this contribution, but is intended for our internal record keeping purposes only. A receipt describing the items donated will be mailed to the address above. Fair market values must be determined by the donor. It is the responsibility of the donor to substantiate fair market value for his/her own tax purposes. It is at the discretion of The Mountaineers to determine the most appropriate use for donated items. The Mountaineers is a 501(c)(3) non-profit organization. Our federal tax identification number is 27-3009280.

In-Kind Contribution Form

Item Information

Item Name:*

Donor Name (who should receive donation credit)?*

Estimated Value $:*

Date of Contribution:*

Item Description:*

Notes:

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

No

Electronic Signature:*

Date:*

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country / Location:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*