DONATE YOUR USED VEHICLE

Please Fill Out the Following Form

Referral Source:    
First and Last Name:    
Address:    
(Location of the vehicle)    
City:    
State:    
Zip Code:    
Phone Number:    
Alternate Phone Number:    
Vehicle Information       
Year:    
Make:    
Model:    
License#:    
VIN#:    
Please Check All That Apply:     2-Door     4-Door    
Station Wagon  4-Wheel Drive
Does the vehicle run and drive as is?    
   
If No, Please explain below
Do you have the Title?    
    
If No, Please explain below
Problems with the vehicle:    
Engine
Transmission
Tires
Body
Other
None

Please briefly explain the problems with the vehicle:
Special Instructions:    

Vanished Children's Alliance
991 W. Hedding Street., Suite 101
San Jose, CA 95126
Ph.(408) 296-1113  Fax. (408) 296-1117
Sighting Hotline. 1(800) VANISHED (826-4743)