Furniture & household item request form
Serving Onondaga County
For surrounding county's services will be provided on a case by case basis and transportation will need to be arranged. We are unable to provide delivery at this time outside of Onondaga County.
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Bedroom furniture
Twin Bed
Full Bed
Queen Bed
Dresser
Night Stand
Twin size bed sheets/comforter
Full bed sheets/comforter
Queen size bed sheets/comforter
Hangers
Other
Kitchen
Plates/bowls
Cups
Pots & pans
Silverware
Strainer
Kitchen Towels
Cooking utensils
Sponge & dish soap
Mop & floor cleaner
Broom & dust pan
Garbage can & bags
Vacuum
All purpose cleaner
Glass cleaner
Dinning room
Table
Chairs
Table Cloth
Living room
Couch
Coffee table & end table
Tv
Lights
Bathroom
Towels
Washcloths
Hygiene items
Shower Curtain
Toilet paper
Bathroom cleaner
Miscellaneous items
Decorations
Curtains and curtain rods
Games
DVD's
Please include any other items you may be in need of below.
Veteran Status
Veteran
Dependent
Active Duty
Did not serve
How many people in your household
Do you need delivery in Onondaga county only?
Yes
No
If your not in Onondaga county please provide a contact info name and number for a person that can help with logistics for transporting items friend, family member, or case manager.
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: