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Wells for Well-Being

Wells for Well-Being, Williamstown ,ON Vehicle Donation Quotation Form
 

Founded by 9 year old Sam Chambre, to provide safe, clean and accessible drinking water to communities that lack this necessity. The first well is finished in Aweil, in the state of Northern Bhar al Ghazal, in the Sudan. At least 100 families are making use of this well. Our next well is in Malawi.

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 Wells for Well-Being.

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=