Content on this page requires a newer version of Adobe Flash Player.
Hours of Operation:
Mon - Fri: 8:00am - 5:00pm
Sat: 9:00am - 12:00pm
Sun: Closed
Donor Information
Name
Phone #
Address
Pick-up Information
Contact Person
Home Phone #
Work Phone #
Address
Vehicle Information
Year of Vehicle
Make of Vehicle
Model of Vehicle
Colour of Vehicle
Vin #
Odometer Reading
E-mail Address:
*
I would like to donate my vehicle to...
Life Renewal Inc.
Anchor
Maranatha Christian School
Emmanuel Christian High School
KIPP Elora
Additional Comments
*
Required
