Name. Address. City. Telephone No. Printable Tribute Donation Form. Send a letter acknowledging this gift to: Name. Address. City.Complete Charity-Donation-Form-9711. This document provides a sample format for a letter acknowledging an in-kind contribution or donation. Pledges can be made up to five years. Let's walk through common examples of donation letters, starting with a template of the basic format to follow. Your gift in their name will help support our programs and services that directly impact our patients. (Physician must complete form DL-101). 5. Would you like to register as an organ donor? This guide outlines how to change your voter registration name or address. Guide.