Your car donation is quick and easy!

We sincerely appreciate your car donation. Just fill out our secure online car donation form on this page and when you are finished click "Submit" to donate your car. Within 24 hours one of our professional towing companies will contact you to make arrangements to pick up your vehicle donation.

The towing company will leave you a towing receipt showing your vehicle was picked-up on behalf of the Cars To Help Kids car donation program. Once we have received your vehicle and title, we will send your tax-deductible donation receipt.

Contact Information

Mr.   Ms.
First Name	Last Name
Daytime Phone   [Area]    [###]    [####]    Ext.    Home Work Cell Enter a valid area code. Enter a valid middle 3 digits. Enter a valid last 4 digits.
Alternate Phone   [Area]    [###]    [####]    Ext.    Home Work Cell Enter a valid area code. Enter a valid middle 3 digits. Enter a valid last 4 digits.
Email Address
Street Address
City
State Select state: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Other	Zip
Is the car located at the above address? Yes   No Same address?

Pick-up Address
City
State Select state: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Other	Zip

How did you hear about the Cars To Help Kids donation program?

Vehicle Information

Year	Make
Model	Color
VIN (if available)	Mileage (if known)
Name on Title	Vehicle Type 2 Door 4 Door Other
Title Available?	Yes   No
Running?	Yes   No
Can drive 20 miles?	Yes   No
Body Condition:	Good   Fair   Poor

Mechanical Condition (check all that apply)

Runs and Drives - No Major Problems
Runs with a jump
Needs transmission work
Needs alternator/starter
Needs fuel pump
Motor knocking
Electrical problems
Overheating
Exhaust problems
Head gaskets problems
Will not start, problem unknown
Other - please specify in field below

Mechanical Needs (max 200 characters)

Other Comments (max 200 characters)

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