Donation Form: KHA-E

Donation From ______________________ Date_____________

Address_____________________________________________

City______________________ State_______ Zip____________

Amount of Gift (dollar value if not money) $_________ to_______
                                                                                 (school or unit)

Description of Gift (if not money)__________________________
____________________________________________________________________________________________________________________________________________________________

________________________________            _____________
Authorized Signature                                                      Date

Superintendent Recommendation Approval _____ Denial _____ 

________________________________            _____________
Superintendent of Schools Signature                          Date

Note: Acceptance of any gift or donation is on a “no strings attached basis: with no obligation implied or expressed by the Board. An attempt will be made, however, to honor the requests for use of the donation.