1-800-227-2643
1-800-227-2643
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Easy Donation Form
Donor Information
Full Name
Please enter your Full Name.
E-Mail
Please enter your e-mail address in the form of user@example.com (limit of 50 characters)
Address
Please enter your street and house number in the form of 1234 Any Street
City
Please enter your City in the form of: Any Town
State
Alabama
Alaska
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Arkansas
California
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Connecticut
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District Of Columbia
Florida
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Hawaii
Idaho
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Maine
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New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
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Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Please choose your State from the list provided.
Zip Code
Please enter your Zip Code in the form 12345 or optionally 12345-6789
Phone Number
Please enter your main telephone number in the form of 123-456-7890, your work phone is optional.
Work Phone Number
Recent photos available?
-
Yes - I have digital photos
No - Please mail camera with donation form
Car/Truck Donation - No photos required
Please tell us if you have recent photos available.
Item Information
Type of Item
Car
Boat
Jet Ski
Truck
RV
Motorcycle
Other
Please select the Item Type of your Donation.
Year
Before 1950
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
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1964
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1977
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1990
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1993
1994
1995
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1997
1998
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2000
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2002
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2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
Do not know
Not Applicable
Make
Please enter the Make of your item.
Model
Please enter the Model of your item.
Trailer Included?
No
Yes
Engine Status?
No Engine
Not Running
Running
How'd You Hear About Us?
-
Postcard
Billboard
Marina Referral
Friends/Family
Bus Stop Ad
Web Search
Please select an option for How You Heard About Us.
Questions, Comments?
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