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Outbound Gift Cards
For auditing purposes, Community Action Network (CAN) is required to track gift card usage.
Please input the following information for each gift card that is given to a client, volunteer, staff member, etc. or that is used by a CAN team member to purchase items related to CAN's mission.
You can review
CAN's Gift Card Policy
here.
How was the gift card used?
Gift card given to client, staff, volunteer, etc.
Gift card used by staff for agency purchases
Recipient Information
Recipient First Name
Recipient Last Name
Phone (From Salesforce or recipient. If unavailable, use 000-000-0000)
Email (
From Salesforce or recipient. I
f unavailable, use noemail@gmail.com)
Zip Code
Recipients must either sign out the card(s) they were given or give verbal consent for a CAN team member to sign the card(s) out on their behalf.
Gift Card Information
If multiple gift cards are provided to the same recipient, please click "Add another response" at the bottom of this section to enter the additional gift card information.
Card Details
Inbound or Outbound
Gift Type
Gift Card Number (the
LAST
6 digits near the barcode, do
not
include the PIN or UPC)
Store
Please select...
Amazon
Costco
Kohl's
Kroger
Meijer
Old Navy
Target
TJ Maxx / Marshalls / HomeGoods
VISA, Mastercard, Other Credit-Sponsored Gift Card
Walmart
Unknown
Other
"Other" Store:
Total Amount on Card
ex. 25
Community Center
Please select...
Arrowwood Hills
Brick
Bryant
Creekside Court
Green Baxter Court
Hikone
Northside
Sustainability
Other
"Other" Location:
Director Email
Gift Card Notes
Purpose of Use
Purpose of Use:
Please select...
Back to School Shopping
Christmas/Holiday Needs
Clothing Needs
Energy Assessment Completion
Gas
Groceries
Household Needs
Medical Needs
Meeting or Event Participation
Moving Expenses
Staff/Intern/Volunteer Appreciation
Thanksgiving Needs
Other
"Other" Purpose of Use:
Date Given to Recipient
Click "Add another response" below if multiple cards are provided to the same recipient.
Recipients must either sign out the card(s) they were given or give verbal consent for a CAN team member to sign the card(s) out on their behalf.
Recipient Signature (type below)
Recipient has given verbal permission for CAN team member to type their signature on their behalf
Date of Signature
Card(s) Used for Agency Purchases
1. If there is a link in the box below, please copy and paste it in your browser for your form:
2. If the box above is blank, please copy and paste this link in your browser for your form:
https://www.tfaforms.com/5066209
Card Closed
*****
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Contact Information