Donation Form Club Name(Required)Your Club NameOther101 Lakes Angola25+ Kiwanians Who Care – INAkron-MentoneAlexandriaAuburnAvonBatesvilleBedfordBloomingtonBoonvilleBremenBrookvilleBrownsburgCambridge City, New DayCarmelCarmel Golden KCastletonChandlerChesterton-DunelandCiceroClarksvilleClay CountyColumbusColumbus Golden KColumbus, MeridianConnersvilleCrawfordsvilleCulverDaleDanvilleDunkirkEast NobleElberfeldElkhartElwoodEvansvilleEvansville-Green RiverFerdinandFishersFort WayneFort Wayne Time CornersFrankfortFranklinGolden K, RichmondGoshenGoshen, Maple CityGrant County, IndianaGreater BlufftonGreater Princeton CommunityGreater SheridanGreencastleGreenfieldGreensburg CommunityGreenwoodHighlandHistoric KokomoHistoric New AlbanyHistoric NewburghHobartHollandHuntingburgHuntingtonIndianapolisIndianapolis-Broad RippleIndy GlobalIndy-It's 5 o'clock SomewhereJasperJefferson CountyJohn Chapman, Fort WayneKnute Rockne Memorial, GrangerKokomoKokomo Golden KLa PorteLafayetteLafayette-HarrisonLakeland, North WebsterLawrence SunriserLawrenceburgLebanonLogansportLogansport and Cass CountyMartinsvilleMeridian Hills, IndianapolisMerrillville-BreakfastMetropolitan KokomoMilfordMitchell-GrissomMonticelloMooresvilleMount VernonMuncieMunsterNappaneeNew Castle Henry CountyNew HarmonyNewburghNoblesvilleNoblesville, SunrisersNorth Clark CommunityNorth IndianapolisNorth ManchesterNorth VernonNorthwest IndianapolisOakland CityOoliticOrleansPendletonPerry Twp.-IndianapolisPeru-GrissomPetersburgPlainfieldPlymouthPortagePortlandPoseyvillePrincetonRichmondRobin Run Golden K-IndianapolisRochesterRush CountySaint PaulScott CountySeymourShelbyvilleSouth BendSouth Central IndianaSouth SpencerTell CityTerre HauteThorntownTipton (Suns of Tipton)ValparaisoValparaiso SunriseVincennesWabashWarsawWawaseeWest AndersonWestfieldWestportWinamacWinchesterYorktownZionsville/WhitestownName of organizationName(Required) First Last Email(Required) Donation Type(Required) Items Monetary (Cash) Monetary (Check) Please select onePersonal toiletries (Approximate #) 0 1-25 26-50 51-75 76-100 100+ deodorant, razor, shaving cream, shampoo, soap, toothbrush, toothpaste, etc.Blanket (Approximate #) 0 1-25 26-50 51-75 76-100 100+ Neck Pillow (Approximate #) 0 1-25 26-50 51-75 76-100 101+ Candy Bars (Approximate #) 0 1-25 26-50 51-75 76-100 101+ Other ItemsPlease provide a description of each item and its respective quantity.Total Monetary Value (Approximate)Cash AmountAmountCheck NumberPlease kindly provide the following detailsWhen the donation was delivered or ordered (Date)(Required) MM slash DD slash YYYY Where the donation was given or placed(Required)To whom the donation was handed(Required)How the donation was delivered(Required)(e.g., plastic bags, boxes, envelopes, etc.) You can also download a printable form and submit it with your donation. Riley_Komfort_Kart_Donation_Form-V02Download
