In-Kind Donation Form
Thank you for contributing to G.E.M.'s disaster relief missions. The following form will be used to coordinate donation deliveries and provide you with a receipt for tax purposes at the end of the year.
 
Please ensure information represents the correct name you would like reflected on your end-of-year giving statement. Every line must be completed to process donation(s).

If any questions, please call 1-800-995-7604 Option #3 or email sue@globalempowermentmission.org and sarahconviser@globalempowermentmission.org
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Donor Name *
Donor Email *
Name of Donor Company *
Company Social Media Handles. Write N/A if not interested in being tagged in public posts *
Donor Legal Address and Address Type (co., residence, organization) *
City and State in which donations are sent from? *
Is this donation used? (Y-N) *
Does this donation still have tags on it? (Y-N-N/A if this doesn't apply) *
How many items are you donating? *
Are all of your donations the same product? (Y/N) *
What are the brands of the items that you are donating? *
What are the number of items that you are donating? (5 boxes of shampoos, 4 pallets of soaps, etc)
What is the number of items that you are donating overall? *
What is the unit price (market value) of each of your donated items? *
What is the TOTAL RETAIL VALUE of your donation? *
How many boxes contain your donations? (Write N/A if this does not apply)
How many pallets contain your donation? Write N/A if this does not apply
How many truckloads will you be donating? Write N/A if this does not apply *
If none of the above apply, please specify the method of packaging and the number of packages that you will be donating *
Will you be dropping off your donation to a GEM or Fulfilment HubUSA location? *
What are the expiration dates of your donated goods? *
Is your donation being delivered via truck, FedEx, UPS or a non commercial vehicle, or via air freight? *
When do you expect GEM or Fulfilment Hub to receive your donation? *
Which mission is your donation intending to support? *
Can your donation be used for other intended missions if there is a surplus of goods and other disasters strike? *
Tax ID number? Please enter n/a if does not apply *
Signature of Donor and Date *
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