Chemeketa Community College Foundation
4000 Lancaster Drive NE
PO Box 14007
Salem, Oregon 97309
503-365-4747
foundation@chemeketa.edu
DONATION Please describe in detail, giving as much information as possible (one item per line,
up to five items per form). Donor provides value of items for tax purposes.
Item:
Value $
Item:
Value $
Item:
Value $
Item:
Value $
Item:
Value $
Signature of Donor
Date
Benefitting Department / Area
By signing this form, the donor relinquishes all rights to the above items to Chemeketa Community
College. To receive a receipt for tax purposes, this form must be complete with an address or email of
the donor. When donating a vehicle valued over $499.99, please contact the foundation directly as
additional information is needed. The foundation is a 501(c) (3) non-profit arm of the college. In
partnership with the college, the mission of Chemeketa Community College Foundation is to support
the college in meeting the needs of students. Tax ID # 93-6097106
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome