ACRC In-Kind Donation Form All in-kind donations made to ACRC must be submitted through this form. A copy of your submission will be emailed to you. "*" indicates required fields First Name*Last Name*Email* This box must be checked before proceeding.* I certify that the information provided in this form is true, complete, and accurate to the best of my knowledge.Month Submitting In-Kind Donation For*Select MonthApril 2025May 2025June 2025July 2025August 2025September 2025October 2025November 2025December 2025Please ensure all time submitted below falls under the month selected here.Date of Service* MM slash DD slash YYYY Hourly RateHours Spent*Service Description*example: I participated in 5 hours of coaching calls at a rate of $150/hr with [name of client]; I completed a written report as agreed for a flat fee; I am requesting travel reimbursement and per diem for an ACRC event.Date of Service MM slash DD slash YYYY Hourly RateHours SpentService Descriptionexample: I participated in 5 hours of coaching calls at a rate of $150/hr with [name of client]; I completed a written report as agreed for a flat fee; I am requesting travel reimbursement and per diem for an ACRC event.Date of Service MM slash DD slash YYYY Hourly RateHours SpentService Descriptionexample: I participated in 5 hours of coaching calls at a rate of $150/hr with [name of client]; I completed a written report as agreed for a flat fee; I am requesting travel reimbursement and per diem for an ACRC event.Date of Service MM slash DD slash YYYY Hourly RateHours SpentService Descriptionexample: I participated in 5 hours of coaching calls at a rate of $150/hr with [name of client]; I completed a written report as agreed for a flat fee; I am requesting travel reimbursement and per diem for an ACRC event.Date of Service MM slash DD slash YYYY Hourly RateHours SpentService Descriptionexample: I participated in 5 hours of coaching calls at a rate of $150/hr with [name of client]; I completed a written report as agreed for a flat fee; I am requesting travel reimbursement and per diem for an ACRC event.Date of Service MM slash DD slash YYYY Hourly RateHours SpentService Descriptionexample: I participated in 5 hours of coaching calls at a rate of $150/hr with [name of client]; I completed a written report as agreed for a flat fee; I am requesting travel reimbursement and per diem for an ACRC event.Date of Service MM slash DD slash YYYY Hourly RateHours SpentService Descriptionexample: I participated in 5 hours of coaching calls at a rate of $150/hr with [name of client]; I completed a written report as agreed for a flat fee; I am requesting travel reimbursement and per diem for an ACRC event.Date of Service MM slash DD slash YYYY Hourly RateHours SpentService Descriptionexample: I participated in 5 hours of coaching calls at a rate of $150/hr with [name of client]; I completed a written report as agreed for a flat fee; I am requesting travel reimbursement and per diem for an ACRC event.Total Hours Spent on Selected Project*Total Amount*If you'd like to include any supporting documents (photos, receipts, etc.), please attach them here.Max. file size: 50 MB.EmailThis field is for validation purposes and should be left unchanged.
