Fun Fest 2010, Let the Reading Begin! A Collaboration of the United Way of Calvert County's Success By 6 Initiative,

Calvert County Public Schools, and the Interagency Council for Children and Families.

The United Way of Calvert County

Federal Tax ID #52-1181917 410.286.0101, phone

530 Main Street, P.O. Box 560 410.535.8987, fax Prince Frederick, MD 20678 www.unitedwaycalvert.org

United Way of Calvert County Donation(s) Due: Friday, April 9, 2010

Contribution Monetary In Kind Services

Name of Contributor: Date:

Agency/Company Name:

Address:

Phone: Fax:

Phone #2: Email:

Monetary Contribution

Amount: Cash Check # _______ Other

In Kind Supplies/Equipment

Materials & Supplies: $

(Description of Donated Material)

Equipment: $

(Description of Equipment)

Donated Services

Date of Service Services Hours of Service Value Per Hour Value of Service

$ Total Value

Receipt of the In Kind Contribution described above is hereby acknowledged by the undersigned authorized employee.

Donor Signature: Date:

Employee Signature: Date:

UW Office Use Only Contact Donation Received Initials Signature Date Complete Date Archived Initials