Acceptance Request for Gifts

Also known as the Gifts-in-Kind form

Please complete this form for any item valued at $1,000 or more and for all gifts involving hazardous materials regardless of value.

Materials or equipment may not be delivered to WPI prior to the submission of this form and department head approval. Any and all materials received become the property of the university and do not belong to any individual. For more information, please refer to the WPI Gifts-in-Kind Policy.

If you need help completing this form please contact your department head.

When you submit this form, a copy is automatically transmitted to your department head, as well as to any offices involved in authorizing the gift acceptance (e.g., Safety Officer of gifts involving hazardous materials). Certain offices requiring additional information may contact you.

Required fields below are marked with an asterisk (*).

* Reporting Department/Division	Select one Administration & Business Affairs Air Force Aerospace Studies Biology & Biotechnology Biomedical Engineering Chemical Engineering Chemistry & Biochemistry Civil & Environmental Engineering Computer Science Electrical & Computer Engineering Fire Protection Engineering Humanities & Arts Information Technology Division Interdisciplinary & Global Studies Library Management Mathematical Sciences Mechanical Engineering Military Science Physical Education & Athletics Physics Social Science & Policy Studies Student Affairs Division University Advancement Division
* Your Name
* Your E-mail
* Donor (name of company/individual)
Donor's Title
* Gift is From	corporation foundation individual a WPI alumnus/a? Yes government agency
* Donor's Mailing Address (for acknowledgement)
Donor's Phone
Donor's E-mail
* Description of Gift	Please include details such as model numbers if appropriate, and note condition of gift if used.
* Gift Use	A brief description of research and/or educational activities that will utilize and benefit from the gift-in-kind. Please mention particular projects or courses in which the gift will be used, if applicable.
* Is this a Company Product?	Yes No
* Is this New or Used Equipment?	New Used
Gift Properties Please check all that apply	Computer Software (if checked, see the section on software below) Computer Hardware Network Hardware Hazardous Materials Scientific Apparatus This is a gift Obtained under contract Personal property such as art, books, collectibles Material for WPI Archives
Please complete this section for gifts of Computer Software only	Number of licenses or seats: Additional staff required? Yes No If license, what is the duration? Is training required to use this software? Yes No Who will maintain the software? IT Staff Dept Staff
Please check if this item involves any of the following	Restricted to particular use Moving, delivery, or installation costs Shipped from outside the U.S. Fees or maintenance costs: $ Additional space, renovations, or alterations Human subjects Animals Testing hazardous materials Select agents Special insurance considerations Use of the item may be hazardous This item must be returned in the future This item must be disposed of in a particular way Training is required
* Gift Value See valuation)	$
* How was gift value determined?	(Note: The Development Office can help determine value.)
* Date of Gift (mm/dd/yyyy)
Expected Delivery Date (mm/dd/yyyy)
Send Copy to me: