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Donation Form


You may use this form to contact us with questions or to donate your vehicle now. A Vehicle Donation Program representative will call you within 1-2 business days.

Contact Information
First Name:  REQUIRED
Last Name:  REQUIRED
Address:  REQUIRED
Daytime Phone: ( ) -  REQUIRED
Alternate Phone: ( ) -

Select a Charity

Vehicle Location
  Check here if vehicle location is
same as Donor address above.
Address:  REQUIRED

Vehicle Information

Vehicle Information
Does your vehicle run and drive?
Do you have the Certificate of Title?


We’ll send you an immediate email confirmation that your donation was received and we’ll call you within a few business hours to schedule your free next day pick-up.

Thank you!

If you have any difficulties with this form or wish to speak with a representative immediately, please call our Customer Service Center toll-free at 1-888-631-6833.


Easter Seals Vehicle Donation Program #1-888-631-6833
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