Catholic Charities of Baltimore: Survey

Vehicle Donation

Contact Information

If you have previously registered, please to prepopulate your information.

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Name:

First Required	Last Required

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Email: Required

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Street 1: Required

Street 2:

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City/State/ZIP:

City Required	State Required	ZIP Required

Yes, I would like to receive e-mail from Catholic Charities of Baltimore

Yes, I would like to receive postal mail from Catholic Charities of Baltimore

Remember me. What's this?

Question - Not Required - Home Phone:

Question - Not Required - Work Phone:

Question - Not Required - Mobile/Other Phone:

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Question - Required - Preferred contact number:

	Home
	Work
	Mobile/Other

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Question - Required - County where the vehicle is located:

Question - Not Required - Pick-up address (where the vehicle is located), if different from your mailing address (include street number, city, state, zip code, and phone number at the pick-up location):

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Question - Required - Year of the vehicle you are donating:

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Question - Required - Make of the vehicle you are donating:

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Question - Required - Model of the vehicle you are donating:

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Question - Required - Color of the vehicle you are donating:

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Question - Required - Mileage:

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Question - Required - State where the vehicle is registered:

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Question - Required - Does the vehicle start? yes
no

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Question - Required - Is the vehicle drivable? yes
no

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Question - Required - Title Number:

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Question - Required - Vehicle Identification Number (VIN):

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Question - Required - Are there any liens on the vehicle? no
yes - Sorry, but we cannot accept vehicles with liens. You will need to obtain a lien release from your lender if the vehicle was financed, even if it is paid off, if the title is not in your name.

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Question - Required - Where did you hear about our program? already familiar with Catholic Charities
church bulletin
friend/family member
search engine
mailing
our website
another website
other