Vehicle Donation Interest Form

First Name:		*Last:
Address1:		Address2:
City:		State:
Zip:		Phone:
	I would like to receive your Seasons newsletter and regular ministry communications.
*E-mail:		Please send me your eNews
Make:		Model:
Condition:		Running Condition:
Year:
Driveable/towable:	yes no
Keys:	yes no
Title:	yes no
Other information:

For more information, please call 262.275.6131