In-Kind Donation Log & Receipt Request Form
Thank you so much for your donation. This form will be used for internal Haley House record-keeping only. We will not share your information.
This should be
Donor First Name
Donor Last Name
Date of Donation
Please indicate when you made the donation.
Men's NEW socks
Men's NEW underwear
Men's Winter/Rain Gear
Accessories (belts, umbrellas, zipper pouches)
Sleeping bags & blankets
Food (approved or from list on website)
Misc. Items from Amazon Charity List
(Estimated) Value of Goods
(Estimated) Number of Items
How will we receive the donations?
I dropped them off at Haley House
I sent them in the mail
I ordered through Amazon Charity Lists and they shipped directly
I ordered online and they shipped directly
Please note: if you are filling this out on behalf of another person/organization, please share your name and contact info here. If you haven't yet dropped off your donation, please indicate when you plan to drop it off here.
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This form was created inside of Haley House.