MCCC - The Hourglass Foundation

"*" indicates required fields

Phone

This field is for validation purposes and should be left unchanged.

Donor/Vehicle Owner Information

Donor/ Vehicle Owner Name (as it appears on the vehicle title):*

First Last

Address

Street Address Address Line 2 City State ZIP Code

Contact Phone

Contact Email

Vehicle Information

Can you tell us how you heard about our Vehicle Donation program?

Do you have a tracking number associated with a donation referral program ? (If not, please input N/A)

What is the Year, Make, Model of the vehicle being donated?*

Please list the VIN#

Color of Vehicle

What is the ACTUAL mileage on the vehicle you're donating? Please do not estimate.*

Is the Vehicle Drivable? (In most instances, we accept vehicles in any condition)*

Yes

Please describe the general condition of the vehicle you are donating.*

Do you have possession of the vehicle title?

Yes

Please attach a copy of the title.

Accepted file types: jpg, gif, png, jpeg, pdf, heic, Max. file size: 256 MB.

Pick-Up Information/Location

Fill out this section only if the pick-up address is different than the owner's address listed above.

Vehicle Owner Name

First Last

Vehicle Pick-up Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Contact Phone for Vehicle Pick-up

Contact Email for Vehicle Pick-up

General Condition of the Vehicle

Please describe the general condition of the vehicle and any additional notes you wish to include.

Tax Receipt Information

Please list the last 4 of the donor's social security number (this is for tax purposes). If the vehicle is jointly owned, list one donor's social security number.*

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We greatly appreciate every single donation! If you have any questions about donating your vehicle, please email us at support@thehourglassfoundation.org.