Section 1: Donor Info 
  
 
 
First name*
 
 
 
 
Last name*
 
 
 
 
Company Name
 
 
 
 
Email*
 
 
 
 
Phone Number*
 
 
 
 
Address
 
 
 
 
Section 2: Donation Details
  
 
 
Type of donation*
 
 
 
 
Brief Description of Item(s) 
 
 
(Brand, item type, or service description- be as descriptive as possible)*
 
 
 
 
Submit a picture of item.  
 
 
File Upload*
 
 
 
 
Section 3: Value
  
 
 
Estimated fair market value ($)*
 
 
 
 
Section 4: Delivery Method
  
 
 
How will you deliver your item(s)?*
 
 
 
 
If you chose to drop off at a United Way office, which location?
 
 
 
 
Section 5: Donation date and acknowledgements
  
 
 
Date donated*
 
 
 
 
I acknowledge this is an in‑kind donation to United Way for Southeastern Michigan, a 501(c)(3).*
 
Yes
No
 
 
 
I understand items must be delivered by Monday, October 19, 2026.*
 
Yes
No