Donation Request Form
Contact
Organization/Non-Profit Name
Contact Person
*
First Name
Last Name
Address (where items will be dropped off)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
example@example.com
What kind of items do your clients need?
General (A mix of everything)
Sweaters
Bras
Professional/Job Interview
Coats & Jackets
Shoes
Pajama/loungewear
Other
Can we list you under organizations we donate to? This is for transparency on our end.
Yes
No
Submit
Should be Empty: