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Alzheimer Society of Oxford

Alzheimer Society of Oxford, Woodstock,ON Vehicle Donation Quotation Form
 

To improve the quality of life for people and their caregivers living with Alzheimer's disease or related dementias. Staff of the Alzheimer Society of Oxford are available to answer questions, provide information and support to those who call or visit the office. The Alzheimer Society of Oxford offers monthly support group meetings in Woodstock, Ingersoll and Tillsonburg. Participants agree that the group setting allows them to openly discuss their feelings, experiences and fears in a non-judgmental and supportive atmosphere.

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 Alzheimer Society of Oxford.

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=