Donation Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Donor Information
Donor First Name:
*
Donor Last Name:
*
Donor Cell Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Donor Email:
*
example@example.com
Donor Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Items Donated
Living Room Furniture
Rows
Qty
Couch/Loveseat/Futon
1
2
3
4
5
6
Chair
1
2
3
4
5
6
Coffee Table
1
2
3
4
5
6
End Table/TV Stand
1
2
3
4
5
6
Bookcase/Storage
1
2
3
4
5
6
Student Desk
1
2
3
4
5
6
Lamp
1
2
3
4
5
6
Picture/Other Decor
1
2
3
4
5
6
Rug
1
2
3
4
5
6
TV/Electronics
1
2
3
4
5
6
Kitchen/Linen
Rows
Qty
Small Appliance
1
2
3
4
5
6
7
8
9
10
Dishes (# of boxes)
1
2
3
4
5
6
7
8
9
10
Cookbook (# of boxes)
1
2
3
4
5
6
7
8
9
10
Linen (# of bags)
1
2
3
4
5
6
7
8
9
10
Pots/Pans/Utensils (# of boxes)
1
2
3
4
5
6
7
8
9
10
General Household
1
2
3
4
5
6
7
8
9
10
Bathroom
1
2
3
4
5
6
7
8
9
10
Home Office
1
2
3
4
5
6
7
8
9
10
Bedroom Furniture
Rows
Qty
Mattress/Boxspring
1
2
3
4
5
6
Bedframe
1
2
3
4
5
6
Dresser
1
2
3
4
5
6
Nightstand
1
2
3
4
5
6
Baby/Kids
Rows
Qty
Crib/Bassinet
1
2
3
4
5
6
7
8
9
10
Toys/Books/School (# of boxes)
1
2
3
4
5
6
7
8
9
10
General Baby
1
2
3
4
5
6
7
8
9
10
Baby Clothes (# of bags)
1
2
3
4
5
6
7
8
9
10
Dining Room Furniture
Rows
Qty
Dining Table
1
2
3
4
5
6
Chair
1
2
3
4
5
6
Clothes
Rows
Qty
Clothes (# of bags)
1
2
3
4
5
6
7
8
9
10
Shoes (# of bags)
1
2
3
4
5
6
7
8
9
10
Notes (quality, brand or other description needed for tax records):
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