Donation Pickup Form - Grand Island

Step 1 of 4

Donation Pickup Request
Pickup Location*

Street Address

Street Address Line 2

CityState

Zip Code
Zip Code Validation
Enter your zip code for the pickup*
Zip Code
Re-Enter your Zip Code*
Zip Code
Pick up only available in the 68801 and 68803 area codes at this time. Call Rick at 308-384-7986 ext.1413 or email rlockard@goodwillne.org for more information or to ask a question about Goodwill Pickup Service.

Step 2 of 4

Donor Details
Desired Pick up Date*

MonthDayYear
Date
Appointment
What is the NEAREST cross street / intersection for the pickup location?
Is this a personal or corporate donation?*
Name*

First NameLast Name
Email**
Subscribe?

I'd like to receive the Goodwill Industries of Greater Nebraska Quarterly monthly e-newsletter.
Phone Number*
Please enter a valid phone number.
Would you like a phone call 30 minutes before your pickup?*

YesNo

Step 4 of 4

Final Items
Why have you chosen to donate to Goodwill?*

I support Goodwill's MissionHome pickup is convenient for meHome pickup is necessary for meOther
Other:*
How did you hear about this service?*
Other:*
Additional Comments / Directions*
Would you consider making a monetary donation to cover the cost of fuel for this free pickup? *
Donation Amount
Minimum donation is $5.00
Donation Total
Payment Type*
Amount Due

Do you understand and authorize the paragraph below?

I authorize Goodwill to pick-up a donation at my residence or business. I understand that no item is guaranteed to be picked up and that pick-up is at the discretion of the Goodwill truck driver. If I intend to include this donation on my income tax filling, Federal tax law states that I must keep the donation receipt that will be supplied to me and all donated items must be in "good used condition or better". I consent to Goodwill employees collecting photos and/or videos of the donations and/or pickup location for internal training purposes.
I understand and authorize*

Yes I understand
Should be Empty:

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