Donation Pick Up Request Form

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Pick-Up Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Furniture Type

Please upload an image of the items you will be donating

Additional image uploader

What is your preferred day for pick-up?

What is your preferred time for pick-up?

Hour Minutes

AM/PM Option

Do you have any comments, notes, or special instructions?

How Did You Hear About Us?

❤️ A fee is required for all Standard Furniture Bank Pickups. The Furniture Bank will provide all donors with a receipt for their tax-deductible donation ❤️

DONATION PICKUP REQUEST FORM