Stair Lift Donation Form

Name

First NameLast Name

Phone Number

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

Email

example@example.com

By providing your phone number and email address, you consent to receive communications from Star Lift LLC regarding appointments, service reminders, technician updates, and account notifications via text message and email. Message frequency varies. Message and data rates may apply for text messages. Reply STOP to opt out of SMS communications or use the unsubscribe link in emails to opt out of email communications.

Please select your City. (*States below are the current Cities we pick-up in*)

Address

Street Address

Street Address Line 2

CityState

Zip Code

What Brand/Model Stair Lift are you looking to Donate?

Would you like a Tax Voucher for your Donation sent to the email above?

Attach a photo of the stair lift

How did you hear about us?

Consent is not a condition of purchase.

Remember to check your email for responses!

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