Donation Designation Form

School Name: (Check One)

Westmoreland High School
Westmoreland Middle School
Westmoreland Elementary School
Date: ___________________
Amount of Donation: $_______________

Cash

Check

Check # ______________

Organization/Individual making the donation: ______________________________________________

Street Address: _______________________________________________________________________
City: __________________________________________ State: _____________ Zip Code: _________
Phone #: _________________________________ Email: ____________________________________
I would like this donation to be used for the following:
Instructional
Band
Music
Library
Technology / Computers
Physical Education
Grounds & Maintenance Expenses
Hospitality Staff (teacher training, staff meals, etc.)
Other General School Uses: (Explain) _________________________________________________
Signature: ___________________________________________________________________________
File a copy of this form with the receipt issued for the donation and keep a copy in your donation file.
Attach the donation allocation report to this form to show how funds were spent. Include the donation
file in your Year End boxes.
Date: ______________________
Receipt #: ___________________
Bookkeeper initials: ___________