Charity Connections - Vehicle Donation - Volunteers of America Oregon

Complete this form to donate your vehicle to a local organization.

About You
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Home Phone*
Work Phone
Cell Phone
Email*
Alternate Pickup Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Pickup Instructions
Charity Partners
Which organization/program would you like to support with your donation?
Volunteers of America Oregon Program
Select one of our Partners
Where would you like to donate your vehicle?
About Your Vehicle
License Plate Number (Current or expired)*
License Plate State*
Is the title in your name?*
- Yes
- No
Title Number*
Title Notes
VIN*
Vehicle Identification Number
Vehicle Year*
Vehicle Body Style
Vehicle Make*
Vehicle Model*
Vehicle Color*
Mileage*
Do you have keys?*
- Yes
- No
Is the vehicle running?*
- Yes
- No
Does the vehicle have all tires?*
- Yes
- No
Vehicle Defects
Body Condition
Mechanical Condition
Interior Condition
Pickup Times
Please list two dates with 3 hour time windows in your schedule for pickup.
Option 1*
Date Format: MM slash DD slash YYYY
Option 2
Date Format: MM slash DD slash YYYY
Comments

Charity Connections – Vehicle Donation