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Jca Uniform Exchange Donation Form
1. JCA Uniform Exchange Donations
Complete the entire form, and place in bag with donated items
Donor Information
Donor Name (Printed as it should appear on receipt or voucher): __________________________
Address ______________________________________________________________________
Phone ______________________________
E-mail ________________________________________________
Item Information
Please 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 Information
Donor Name (Printed as it should appear on receipt or voucher): __________________________
Address ______________________________________________________________________
Phone ______________________________
E-mail ________________________________________________
Item Information
Please list all items you are donating to the School Uniform Exchange, and please be specific. For
example…3 navy blue
polo shirts, 2 pair of girls’ khaki pants size 8.
Item Name and Description: _____________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Donor Signature ____________________________________ Date ______________________