GHAR | Vehicle Donation Form

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Request ID

Status*

Donation Date

Partner

Check if this donation is from a company

Company Indicator

First Name

Last Name*

Mailing Address

City

State

Zip

Date of Birth

Primary Phone*

Alternate Contact Name

Alternate Phone

Year*

Make*

Vehicle Make

Standardize the Make value provided by the donor

Model*

Vehicle Model

Standardize the Model value provided by the donor

Color

I have the title

If the vehicle is not at the location (Mailing Address) above, check and provide the location in the box that opens below

Check if vehicle location is not the same as above

Alternate Vehicle Location

Vehicle Location Status

Select current location of vehicle

Vin

Odo

The vehicle runs

Describe damage to body

Details of mechanical concerns

How did you hear about Give Hope a Ride?*

Referrer

Notes

Create Date

Reviewer

Review Date