Fillable Donation Form (Indian Hills Community College)

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Donation Form (Indian Hills Community College)

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File type: PDF

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EQUIPMENT/MATERIALS DONATION TO
INDIAN HILLS COMMUNITY COLLEGE
Donor Information
Individual Donor Name:
Business Donor Name (if
applicable):
Business Donor Contact:
Street address:
City: State: Zip code:
E-mail address: Phone:
Donation Information
Date of Donation:
Description of Donated Equipment/Materials (If Applicable, Include Make/Model/Serial No., etc.):
IHCC Costs Involved in
Acceptance of Donation:
Restrictions on Disposal:
IHCC Program Benefitting
from Donation:
Location @ IHCC:
IHCC Inventory & Insurance Value (Attach Proof):
Signature of Originator
Date
Signature of Department Supervisor or Dean
Date
Printed Name
Printed Name
Date Form Submitted to Business Office:
IA
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Donation Form (Indian Hills Community College)

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Completed 18 July 2020

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