Lend A Secondhand Inc. Donation Request Form
Lend A Secondhand, Inc. is all about doing their part to ensure clothing, footwear, and gear that are in great condition continue to add value to families in our communities. Please complete this form in it's entirety. The information submitted will be held confidentially. You will receive a response within 72 hours of your request being received. Please add our email address (info@LendASecondhand.com) to your contacts to ensure message delivery.
Does this request come from an individual or an organization?
*
Individual
Organization
Organization Name
Is this an URGENT request?
*
Yes
No
Name of Requestor
*
First Name
Last Name
Email of Requestor
*
example@example.com
Phone Number of Requestor
*
The best way to reach me concerning this request is:
Text message to the number above.
Phone call to the number above.
Email to the email address above.
Address of Requester
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Briefly explain the circumstances surrounding your donation request. If this request is urgent, please provide justification for the urgency.
*
Age of Child
*
Has this child received a donation from us within the past 6 months?
*
Yes
No
Sex of Child
*
Boy
Girl
Child's Shirt Size
*
Child's Pants Size
*
Child's Shoe Size
*
My child is in need of:
*
Ex. A coat, jeans, winter boots, shorts, pajamas, etc.
If your request is approved, are you able to pick up your items in Hampton, VA or should they be mailed?
*
I live within 20 miles of Hampton, VA and can pick up my items.
I live farther than 20 miles of Hampton, VA, please mail the items to me at the address listed above. (Please note this may result in a delay in you receiving your items.)
Signature of Requestor
*
I understand that the personal information above will be held confidential by Lend A Secondhand, Inc. and that only my child's sizes will be shared with Secondhand Stylish LLC after my request has been approved if my child's size is unavailable at Lend A Secondhand, Inc.
Submit
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