Donation Pick Up Request Form

Donation Pick Up

Upon receiving a request for donation pickup, a CommunityWorx representative will contact the donor by phone, text, email, to confirm the request. CommunityWorx is currently receiving a very high demand for donation pick ups, therefore requests will be assessed before approval. CommunityWorx may not accommodate all donors or approve all requests. The CommunityWorx team appreciates your countined support.
Appointments are made in one hour intervals. The dates and times presented are currently what we have available. Please choose the date and time when a responsible adult will be at the location to receive our drivers.
Donor's Name*

First NameLast Name
Pick up Address*

Street Address

Apartment, unit, or Suite

CityState / Province

Postal / Zip Code
Donor's Phone Number*

Area CodePhone Number
Is this a cell phone number?

YesNo
Donor's email address*
example@example.com
Preferred communication*

Phone callPhone text (SMS)Email
What type of place is the pick up location?*

Single unit residence (house)Multi-unit apartment (condominium building or complex)Mobile home parkBusiness or officeOther
Are stairs or an elevator accessible to our drivers while moving you donation?

Yes- more than two flights of stairs are required.Yes - an elevator with ample room is accessible.Easily accessible - the merchandise is on the ground floor.It will be challenge to move this through the building - please bring more than two people.
Does your household have pets? If so, please list all pets in your household. [Employees may have allergies. We ask that you put your pets away and please clean any dander/hair off of the items to be donated.]*
Ex: One big dog, 2 long-haired cats, a bird in a cage, etc.
Where can our drivers park a large box truck during this pick up?
Parking lot, street parking, in the driveway...
A picture of the entrance of your building can sometimes help our drivers plan ahead. Please snap a picture of the entrance or any areas that our drivers may need to pre-plan for and upload it here.
Is there anything else we need to know about accessing or moving your donation?
What is the estimated value of the item you would like to donate? (if more than three items please indicate below)

$* Estimated value
Item 1: What is the item you are trying to donate? Is there anything about these items that you think we should know? *
Ex: 3-Seater leather couch. This couch has a hole on one cushion. The legs are able to be screwed off. It did not fit through the main door of the house.
Item 1: What is the condition of the items you'd like to donate?*

Excellent Condition - it looks brand newGood Condition - clean, no major scratches, tears, animal hair etc...Some wear and tear - may need some cleaning or repair before it's made available to others in our community.Bad condition - I just need it out of my place- may be used for parts or recycled.
Please upload a picture of item 1*
Optional- upload a picture from a different perspective
Do you have a second item you'd like to donate?

YesNo, that's all for now
Item 2: What is the estimated value of the item you would like to donate? (if more than three items please indicate below)
$ Estimated value
Item 1: What is the item you are trying to donate? Is there anything about these items that you think we should know?
Ex: 3-Seater leather couch. This couch has a hole on one cushion. The legs are able to be screwed off. It did not fit through the main door of the house.
Item 2: What is the condition of the items you'd like to donate?

Excellent Condition - it looks brand newGood Condition - clean, no major scratches, tears, animal hair etc...Some wear and tear - may need some cleaning or repair before it's made available to others in our community.Bad condition - I just need it out of my place- may be used for parts or recycled.
Please upload a picture of item 2
Please upload a picture of item 2 from a different perspective.
Do you have a third item you'd like to donate?

YesNo, that's all for now
Item 3: What is the estimated value of the item you would like to donate? (if more than three items please indicate below)

$ Estimated value
Item 1: What is the item you are trying to donate? Is there anything about these items that you think we should know?
Ex: 3-Seater leather couch. This couch has a hole on one cushion. The legs are able to be screwed off. It did not fit through the main door of the house.
Item 3: What is the condition of the items you'd like to donate?

Excellent Condition - it looks brand newGood Condition - clean, no major scratches, tears, animal hair etc...Some wear and tear - may need some cleaning or repair before it's made available to others in our community.Bad condition - I just need it out of my place- may be used for parts or recycled.
Please upload a picture of item 3
Please upload a picture of item 3 from a different perspective
Do you have a fourth item you'd like to donate?

YesNo, that's all for now
Item 4: What is the estimated value of the item you would like to donate? (if more than three items please indicate below)

$ Estimated value
Item 1: What is the item you are trying to donate? Is there anything about these items that you think we should know?
Ex: 3-Seater leather couch. This couch has a hole on one cushion. The legs are able to be screwed off. It did not fit through the main door of the house.
Item 4: What is the condition of the items you'd like to donate?

Excellent Condition - it looks brand newGood Condition - clean, no major scratches, tears, animal hair etc...Some wear and tear - may need some cleaning or repair before it's made available to others in our community.Bad condition - I just need it out of my place- may be used for parts or recycled.
Please upload a picture of item 4
Please upload a picture of item 4 from a different perspective.
Are you donating MORE than what you listed above?

YESNO
Should be Empty: