House of Mercy Online Donation Receipt
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ONLINE DONATION RECEIPT
Name
*
First Name
Last Name
Email
*
Verify Email
*
Phone
Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Is this a special event donation?
*
If yes, select the program.
No
Back to School
Christmas with Mercy
Tushies & Toes
Lenten Cross
Is this a goods or food donation?
*
Goods
Food
Pounds
Enter # of pounds for food donation if needed for receipt.
Goods Type
*
Clothing/Shoes
Household Goods/Home Decor
Toys
Linens
Furniture
Other
Items Donated
Use this field for a more specific list of your donated items for your own records if desired. If you have a long list, you may attach it to a printed copy of your email receipt for tax purposes, just add "See List" to the field above.