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Aplastic Anemia and Myelodysplasia Association of Canada

Aplastic Anemia and Myelodysplasia Association of Canada, Richmond Hill,ON Vehicle Donation Quotation Form
 

The Aplastic Anemia & Myelodysplasia Association of Canada (AAMAC) is a leading funder of research into bone marrow failure diseases in Canada. Our volunteer-run organization supports patients and caregivers across the country who are living with aplastic anemia, myelodysplastic syndrome (also called MDS or myelodysplasia) and paroxysmal nocturnal hemoglobinuria (PNH).

Vehicle Donation Quotation Form

Please note: By filling out the form below you are not committed to donating your car. Filling out this form will allow us to contact you with a quote on the price the charity of your choice will receive for your vehicle. All personal data is kept strictly private and will never be sold.
 
Owner Information Section
Name * State/Province *
Address on Ownership * ZIP/Postal Code *
City *
Daytime Phone Number * Phone/Cell/Work Number *
Email *

Donating Your vehicle?

Yes, I want to donate my vehicle to Aplastic Anemia and Myelodysplasia Association of Canada.

Vehicle Information Section

Year * Make *
Model * Mileage
License Plate VIN #
 If your vehicle is located at a different address from your home address, please check the box and then complete the following section, if same as home address (skip)
Condition of vehicle Comments about vehicle
*
I do have the ownership / title to transfer to the Authorized Treatment Facility.

Vehicle Images Section
Uploading images will help us to better determine the value of your vehicle, possibly increasing what we will pay for your car.

Human? Answer this question 4+7=