In-kind Donation Form
Jean C. Poth
Vice President for Institutional Advancement
Executive Director, NECC Foundation, Inc.
100 Elliott Street, Haverhill MA 01830
Donor please complete the following:
Date of donation:
Donor Full Name:
Organization Name:
Mailing Address:
City, State and Zip:
Signature of donor:
Please note: Donations of gifts in kind are accepted with the understanding that the materials become the property of Northern Essex Community
College, and that the value is the responsibility of the donor. In turn NECC may use, keep, or dispose of items at its discretion.
NECC Contact:
Donor please complete the following:
Item Description: Quantity: Estimated Fair
Market Value:
Org #: Asset #:
If you have any questions or need assistance, contact Jean Poth at 978-556-3624.
Instructions for completing the In-kind Donation Form:
1. The Estimated Fair Market Value must be completed by the donor.
2. Donor to provide detailed information related to their contact information and full description
of the item or service being donated.
3. Mail completed form to the Office of Institutional Advancement for proper recording and
acknowledgement of gift. See address above.