Board In-kind Report

Name:*

Email:*

In-kind type: Time

Board Volunteer Hours

Please describe:

In-kind type: Professional Services

Professional services are described as services performed by a board member outside your normal board activities based on your specialty or area of expertise, i.e. attorney, advocacy, etc. Additional paperwork may be requested as a supplement to this form, for example, an invoice or letter explaining service. If you would like to supply supplemental materials, please use the upload field below.

Value of Professional Services: $

Upload supplemental documents:

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Description of services:

In-kind type: Travel Expenses

Insert total number of miles traveled. Contribution will be calculated at $0.14/mile.

Mileage Contribution: $

Airfare: $

Upload receipt:

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Tolls: $

Upload receipt:

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Meals: $

Upload receipt:

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Total In-kind Contributions:

Total in-kind contribution for your time: $

Total in-kind contribution for professional services: $

Total in-kind contribution for travel expenses: $

Total In-kind contributions: $

Electronic Signature:*

By signing, I certify that this in-kind contribution information is a true reflection of my time and expenditures and will be used as a match against the FHC’s federal funding received from the National Endowment for the Humanities.