Do you have a car that you’re interested in donating? Fill in the form below and we’ll be in touch. Contact InformationName First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneEmail Pickup/Drop-offPickupDrop-offVehicle InformationMake Model Year Colour V.I.N. Odometer Reading Odometer Units Kilometers Miles Check if the odometer does not show actual distance traveled. Check if the odometer does not show actual distance traveled. Car Condition What kind of condition is the car in?Engine Good Ok Poor Not Running Brakes Good Problems Transmission Good Ok Poor Not Working Transmission Type Standard Manual Tires Good Ok Poor Emissions Test Failed Last Test Passed Last Test Electrical Good Problems Body Damage Rust Windshield Good Chips Cracks CommentsIs there a lean against the vehicle? Yes No Used as a taxicab or police vehicle? Yes No Vehicle in an accident during or prior to ownership? Yes No If yes, please provide details I hereby donate this vehicle in its current condition to Southwestern Ontario Youth for Christ.Signature
