Americanfamilycharity.org

American Family Charity - Vehicle Donation Form

You may also call us at (800) 916-7788


Name (First and Last):
Street Address:
City:
State:	California
Zip:
Best Phone Number:
Other Phone :
Best time to call :
E-Mail Address :
Vehicle Info
Year :
Make :
Model :
Does the vehicle run? :	yes no
Do you have the title? :	yes no
Is title in donors name? :	yes no
Is vehicle currently registered? :	yes no
Do you have the keys? :	yes no
Are any tires flat? :	yes no
Is vehicle intact?:	yes no
Please explain any mechanical problems : This information helps our volunteer mechanics locate and fix any problems.
Is your vehicle located at a different address? : If Yes, enter address below	yes no
Where do we pick up the vehicle?
Vehicle Address: Leave blank if the same
City :
State :
Zip :
How did you heard about American Family Charity? :