Vehicle Donation Form - New England - American Lung Association

Vehicle Donation Form - New England

Thank you for choosing to donate to the American Lung Association in New York. Once you have completed the online application, you will be contacted to complete your donation request.

If you have any questions at anytime during the donation process, please call 781 890 4262.

* Indicates a required field.


*	First Name: Required
*	Last Name: Required
*	Email: Required
*	Street 1: Required
	Street 2:
*	City: Required
*	State / Province: Required
*	ZIP / Postal Code: Required
*	Phone Number: Required
	Yes, I would like to receive e-mail from the American Lung Association
	Remember me. What's this?

Please provide some information about your vehicle.

*2.

Question - Required - Vehicle Type:

*3.

Question - Required - Vehicle Make:

*4.

Question - Required - Vehicle Model:

Question - Not Required - Vehicle Year:

Question - Not Required - Vehicle Color:

Question - Not Required - Doors:

Question - Not Required - Driveable: Yes
No

Question - Not Required - Approximate Mileage:

10.

Question - Not Required - VIN #:

*11.

How did you hear about our program?

(Select one of the available choices or enter a different value.)
Question - Required -

The American Lung Association is a non-profit, 501(c) 3 corporation, so your donation may be tax deductible. Your vehicle will be sold by a licensed dealer with the proceeds benefiting the American Lung Association. We will work hard to maximize your eligible tax deduction.

Click here for more information on tax deductions.

Vehicle Donation Program

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