Horizons for Homeless Children

Once your in-kind donation (tangible or intangible) is ready for delivery to Horizons, the form below must be completed. This form is used to provide information for accurate description of the item or service and to prepare receipts for tax purposes.

PLEASE DO NOT FILL OUT THIS FORM UNTIL ALL DONATION ITEMS ARE COLLECTED AND READY FOR DROP-OFF.

The donor is the person or company/organization actually donating the item. The contact name is the person filling out the form.


*	First Name: Required
*	Last Name: Required
*	Email: Required
*	Street 1: Required
	Street 2:
*	City: Required
*	State / Province: Required
*	ZIP / Postal Code: Required
*	Phone Number: Required
	Employer:
*	Occupation: Required
	By filling out this form, you will receive periodic updates from Horizons.
	Yes, I would like to receive postal mail from Horizons for Homeless Children

Question - Not Required - Donor Name (If different from Contact):

Question - Not Required - Donor Organization (if different from contact):

Question - Not Required - Donor Phone (If different from contact)

Question - Not Required - Donor Email (if different from contact):

*

Question - Required - Itemized Description of Donated Item(s) or Service(s):

*

Question - Required - Estimated Fair Market Value (determined by donor)

*

Question - Required - When would you like to drop off your donation (Drop-offs take place between Monday-Friday between 9am-5pm)

Month

Day

Year

*

Question - Required - If you are donating these items directly to one of our Playspace Programs, have you been in contact with a Playspace Program staff member regarding your donation and/or drop off coordination?

*

Question - Required - Donor E-Signature (please type your name to verify that the estimated fair market value was provided by the donor)

*

Question - Required - Please record the text displayed below:

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Horizons for Homeless Children is a 501(c)(3) non-profit organization.
Your donation is tax-deductible as allowed by law. Tax ID/EIN: 22-29-15188.

In-Kind Donation Form