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Simple Donation Form - Made Quick & Easy
Fill out the form to help your Charity.
Please select the Charity you wish to donate
Select
AIDSNET
American Council of the Blind
American Council of the Blind of Oregon
American Council of the Blind of Texas
CASA
Cube Together
Find the Children
Hollywood Food Coalition
Outdoor Outreach
Patriotic Hearts
Rotary Club of Glendora
Stray Pets in Need
United Breast Cancer Foundation
Youth for Human Rights International
Iowa Council of the United Blind
Select Vehicle or Boat
Select
Vehicle
Boat
Please select the type of vehicle you will be donating
Select
Car
Truck
SUV
Van
RV
Other
Boat Donation
Year
Make
Model
Does it run?
Select Option
Running
Not Running
Is the Boat currently registered
Select Option
Yes
No
Overall condition
Select Option
Excellent
Good
Fair
Poor
Boat Type
Select Option
Motorboat
Sail Boat
Motor Yacht
Catamaran Boat
Cabin Cruiser
Pontoon
Fishing Boat
Trawler Boat
Deck Boat
Bowrider Boat
Houseboat
Boat Length
Year Last Used
Link to photos (if available)
Any additional information you can provide would be appreciated! Do you know the horsepower of the engine? Condition of sails? Extra features?
Notes or Questions
Vehicle Donation
Year
Make
Model
Does it run?
Select Option
Running
Not Running
Do you have the title?
Select Option
Yes
No
Any major damage?
Select Option
Yes
No
Additional Vehicle Information
Mileage
Color
VIN (if available)
We can accept cars with no title and/or in poor condition, but we may choose to send those to a different company for pickup. Any information you can provide to help us make that decision would be appreciated (e.g. body damage description, if any). If your older vehicle has exceptional low mileage or might be considered a CLASSIC, please let us know that also!
Notes or Questions
Donor Information
First Name
Last Name
Email
Day Phone
Cell Phone
Evening Phone
I give permission to receive text messages / Op-In SMS / Please Select "Yes or No"
Select Option
Yes
No
Mailing Address
Street Address
City
State
Select State
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
Pick-up Address
My Donation can be Picked-up at the Mailing Address
Add a Different Pick-up Address
Pick-up Street Address
Pick-up City
Pick-up State
Select State
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Pick-up Zip Code
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