JCA Uniform Exchange Donations

Complete the entire form, and place in bag with donated items

Donor InformationDonor Name (Printed as it should appear on receipt or voucher): __________________________Address ______________________________________________________________________Phone ______________________________ E-mail ________________________________________________

Item InformationPlease list all items you are donating to the School Uniform Exchange, and please be specific. For example…3 blue polo shirts size 8, 2 pair of girls’ khaki pants size 8.Item Name and Description: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Donor Signature ____________________________________ Date ______________________Check appropriate selections:_____ I do not wish to receive a credit voucher for the items I have donated. I understand that my donation is tax deductible according to IRS standards._____ I wish to receive a credit voucher for the items I have donated._____ My items are new or laundered (gently used), have all buttons/zippers/etc., conform to the standard school attire policy of Jericho Christian Academy and have no stains or tears._____ I understand that my voucher will be available at the registration table during the scheduled Uniform Exchange Hours_____ I understand that JCA will not pay cash for any donated items or unused vouchers._____ I understand JCA will have no control over and cannot guarantee the availability or quantity of items, sizes, colors, etc. at the exchange. All exchanges will be on a first-come, first-served basis.*If you wish to receive a credit voucher, you must check that you understand and agree to the terms above.Staff member/volunteer who received/inventoried ________________________ Date ________

Staff/Volunteer Notes:

Cut along this line and retain for you records_____________________________________________________________

JCA Uniform Exchange Donor InformationDonor Name (Printed as it should appear on receipt or voucher): __________________________Address ______________________________________________________________________Phone ______________________________ E-mail ________________________________________________

Item InformationPlease list all items you are donating to the School Uniform Exchange, and please be specific. For example…3 navy bluepolo shirts, 2 pair of girls’ khaki pants size 8.Item Name and Description: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Donor Signature ____________________________________ Date ______________________