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Community Living Ajax Pickering Whitby

Community Living Ajax Pickering Whitby, Ajax,ON Vehicle Donation Quotation Form

It is the mission of the Association to promote social inclusion for individuals with a developmental disability and provide a wide range of options including; residential supports, Vocational Supports, Community Access Supports, Specialized Services, Support Families. All individuals should be provided with a wide range of options to meet their full potential: residential, employment, recreational, social, health and education.

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 Community Living Ajax Pickering Whitby.

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=