In-Kind Investment of Goods & Materials Form
Thank you for your investment into KairosPDX by providing goods and materials that can benefit our community.
Please note you will need to obtain information for the six categories listed below. All categories are required to complete the form.
Date Investment Provided to KairosPDX *
MM
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DD
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YYYY
Item (s) being invested into KairosPDX NOTE: If there are several items that can be categorized you do not need to list them out separately. *
Quantity of Items Please list for all *
Estimated Cash Value ( Must be provided directly from the person providing the item *
Contact information for Investor. Please include both a Contact Name, Postal Address and an Email Address. If the Investment is via a Company, please provide the Company name, a Contact Name, Postal Address and an Email Address. *
Please list the name of your contact from KairosPDX? *
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