Go to Our US Site
Phone Us At
1-877-363-6354

ALS Society of Canada

ALS Society of Canada, Markham,ON Vehicle Donation Quotation Form
 

ALS, more commonly known as Lou Gehrigs disease, is a rapidly progressive and fatal neuromuscular disease that causes the degeneration of nerve cells in the brain and spinal cord. The ALS Society of Canada, founded in 1977, is the only national voluntary health organization dedicated solely to the fight against ALS and support for those living with ALS. The Society funds research towards a cure for ALS and supports our provincial partners in the provision of quality care for those living with ALS.

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 ALS Society 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=