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Epilepsy Ontario

Epilepsy Ontario, Thornhill,ON Vehicle Donation Quotation Form

The objective of Epilepsy Ontario can be summarized into one statement: to provide support, education and information for chapters to serve those with epilepsy and the communities at large. The importance of these functions at the provincial and chapter level are not necessarily in that order. Education is seen by many to be the most important function while others believe that support through self-help groups and public information is more important. The Provincial office provides counseling services, library facilities, medical and psycho-social resources, advocacy, educational material and public information pamphlets.

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 Epilepsy Ontario.

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=