ARAHA Car Donation Form

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Email *

First and Last Name *

Address *

Email *

Phone Number *

Vehicle Make, Model, and Year *

Vehicle Mileage *

Vehicle VIN Number *

Does the vehicle run? *

Yes

Do you have the vehicle's title? *

Yes

Briefly Describe the Vehicles Condition *

By signing this form, I acknowledge that my vehicle has been donated to the American Relief Agency for the Horn of Africa (ARAHA) for charitable purposes. The vehicle will be taken/received by Affordable Auto Works on behalf of ARAHA and its value will be determined on the condition of the car and its resale value in the Market. (Type full name below as signature) *

Form Completed On *

YYYY

A copy of your responses will be emailed to the address you provided.

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