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Car Donation Program
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Car Donation Program
* required information
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Contact Information
You will be contacted by Vehicles for Charity within 2 business days of submitting this form.
Title:
-- please make a selection --
Admiral
Ambass. & Mrs.
Ambassador
BGEN
Bishop
Bishop and Mr.
Bishop and Mrs.
Brother
Cantor
Cantor and Mr.
Cantor and Mrs.
Capt.
Capt. and Mrs.
CDR
Cdr.
Chap.
Chaplain & Mrs.
Cmdr.
CMSGT
Col.
Col. and Mrs.
Commissioner
CWO4
Deacon
Dr.
Dr. & Rev.
Dr. and Dr.
Dr. and Mr.
Dr. and Mrs.
Dr. and Ms.
Dr. and Rev.
Drs.
Elder
Estate of
Father
Fr.
General
H.R.H.
Hon.
Judge
Lt.
Lt. Cmdr.
Lt. Col.
Major
Messrs.
Miss
Monsignor
Mother
Mr.
Mr. and Mrs.
Mr. and Ms.
Mrs.
Ms.
MSG.
Mss.
Prof.
Prof. and Mr.
Prof. and Mrs.
Prof. and Ms.
Rabbi
Rabbi and Mr.
Rabbi and Mrs.
Rep.
Rev.
Rev. and Mr.
Rev. and Mrs.
Rev. Dr.
Rev. Dr. & Mrs.
Rt. Rev.
Rt. Rev. & Mr.
Rt. Rev. & Mrs.
Senator
Senator & Mrs.
Sgt.
Sister
Sr.
The
The Hon.
The Hon. & Mr.
The Hon. & Mrs.
The Rev. Deacon
First Name:
*
Last Name:
*
Address Line 1:
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Address Line 2:
City:
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State:
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California
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Marshall Islands
Maryland
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Northern Mariana Islands
Ohio
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Palau
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Puerto Rico
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Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
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Not in USA
ZIP/Postal Code:
*
Email:
*
Phone:
*
Business Phone:
Cell Phone:
How did you hear about us?:
-- please make a selection --
CHS Supporter
CHS Volunteer
CHS Event
Friends
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Social network
Direct mailings
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Print advertisements
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Other
If other, please enter how you heard about us:
Additional Information
If vehicle/vessel location is not at the address above, please list street address, city, state and zip code in the box:
Vehicle/Vessel Year:
Vehicle/Vessel Make:
Vehicle/Vessel Model:
VIN/Hull #:
License/CF #:
Please check all characteristics that apply to your vehicle.:
2-door
4-door
Hatchback
Station Wagon
SUV
Pickup Truck
Convertible
4WD
Does the vehicle run and drive as it is right now?:
Yes
No
If no, when was the last time the vehicle was driven?:
Do you have the title?:
Yes
No
If no, please explain:
Please describe the mechanical condition of the vehicle/vessel.:
Please describe any damage to the vehicle/vessel.:
Special instructions:
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For more information, contact Vehicles for Charity at 1-866-628-2277 or via email: cars@arcthrift.com. Vehicles for Charity, a division of Arc Thrift Stores, Inc., processes auto donations for CT Humane Society.
Car Donation Program
Ways to Give
Donate Now
Memorial and Tribute Giving
Monthly Giving
Planned Giving / Estate Planning
Make a Gift of Impact - Stocks
Workplace Giving/Corporate Gifts
Co Venture Inquiry
Wish List
Buy 2 Give
Shop Online
Shop Local
Pet Food Pantry
Donate Your Vehicle
Car Donation Program
A Donor Bill of Rights
Copyright 2013 Connecticut Humane Society