Mike's Rides for Lives Nominee Application 2023-2024
To be eligible, a person must have a unique situation that can only be relieved by having a gifted  car. They must live in the Kitsap County and surrounding areas and agree to hold Mike’s Rides for Lives, Inc. harmless from damages. The recipient must also be able to provide automobile insurance on the vehicle provided at time of delivery.

Qualifications
Must be a resident of Washington state
Have a valid current driver’s license
Must be insurable
Agree to background check/state patrol driving record check with application
Agree with additional release of information/criteria if required by the MRFL selection committee for marketing purposes
Name
*
First and Last Name
Address
*
Please include Street Address, City, State, Zip Code and Apartment/Unit#
Email *
Phone number *
Does the Nominee have a valid drivers licenses in Washington State?
*
Is the nominee able to obtain auto insurance at time of delivery?
*
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy