Your Vehicle Donation SAVES LIVES

Thank you for your interest in donating your vehicle. This survey will take just a few minutes to complete, then we'll be able to take that vehicle off your hands.

And remember, we accept almost all automobiles, boats, motorcycles and RVs—running or not!

First Name*

Last Name*

Email*

Mobile Phone*

Street 1*

Street 2

City*

State*

Zip*

Vehicle Year*

Make*

Model*

Vehicle License #*

Vehicle Mileage*

Is the vehicle at the same address as above?* YesNo

Please select all that apply* The vehicle is registered in my name.I have current registration.I have the title.Vehicle has tires, wheels, engine, transmission.The tires are flat.The vehicle is in running condition.The vehicle body is in good shape.All trash & personal belongings are removed.The vehicle has keys.

How did you find out about our vehicle donation program? All Things Pawsible quarterly newsletter A friend/coworker HSSV Mailing HSSV Billboard HSSV events Newspaper Television At HSSV Shelter Search Engine ie Google, Yahoo (Identify which one below) Radio Other

If you selected event, newspaper, search engine or other, please elaborate:

I would like to receive email communications from HSSV. Yes

Comments

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