Donor Registration

DONOR REGISTRATION FORM

Name of Business, Organization Or Individual:

Name of Primary Contact Person:

Your Physical Address Street :

City:

State:

Zip:

Mailing Address (if different):

Phone:

Fax:

Pager/Cell:

Email:

What Item Would You Like To Donate:

Approx. Weight of Item:
lbs.

Approx. Volume of Item:
cft.

Approx. Value of Item:

Describe the item if need be, or leave comments :

May this item may be sold to support the nonprofit organizations operations:
Yes No

I will store the item for up to days before disposing of it.

Name of Business, Organization Or Individual:
Name of Primary Contact Person:
Your Physical Address Street :
City:
State:
Zip:
Mailing Address (if different):
Phone:
Fax:
Pager/Cell:
Email:
What Item Would You Like To Donate:
Approx. Weight of Item:	lbs.
Approx. Volume of Item:	cft.
Approx. Value of Item: