In-Kind Donation Form - Arthur M. Blank Hospital
Thank you for your support of Children's Healthcare of Atlanta by making an in-kind donation.
Are you making this donation as an individual or on behalf of an organization?
*
Individual
Organization
Organization Name
Name
*
Mr.
Mrs.
Ms.
Miss
Dr.
Prefix
First Name
Last Name
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Yes! I want to be able to receive emails from Children's Healthcare of Atlanta Foundation staff, leaders, and programs.
Yes
Number of items donated
*
Is this donation
*
New
Used
Is this item handmade?
*
Yes
No
Donation description
*
Are you a current or former patient family?
*
Yes
No
Submit
Should be Empty: