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Truck Donation Pickup Form
Please provide your information here. Items marked with an (*) require a response.
First Name *
Last Name *
Daytime Phone *
Address *
City *
State *
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AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
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NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip *
Email Address *
Directions to pickup location:*
Items to be picked up: *
How did you hear about the Home Store? *
Gave before
Realtor/Brochure
Phone Book
Friend
Partner Family
Church/Faith Community
Shopped at Home Store
Referred by another thrift store
TV/Radio/Newspaper
Other
You will be contacted by our scheduling coordinator within 2 business days of submitting this form.
Home
|
Volunteer
|
Donations
|
Homeownership
|
Where We Build
|
Home Store
|
News & Events
|
About Us
|
Deconstruction
|
Contact Us