ALS Hope Foundation

ALS Hope Foundation, Philadelphia,PA Vehicle Donation Quotation Form

ALS Hope Foundation's mission is to provide long-term support to 1) basic and clinical research programs leading to a cure, 2) clinical centers of excellence for the care and treatment of patients with ALS, 3) support programs for patients and care-givers that optimize care and promote independence of the patient, and 4) programs that promote patient and physician education about the diagnosis, treatment and caring for the patient with ALS. Located in Philadelphia.

Vehicle Donation Quotation Form

Please note: By filling out the form below you are not committed to donating your car. Filling out this form will allow us to contact you with a quote on the price the charity of your choice will receive for your vehicle. All personal data is kept strictly private and will never be sold.
Owner Information Section
Name * State/Province *
Address on Ownership * ZIP/Postal Code *
City *
Daytime Phone Number * Phone/Cell/Work Number *
Email *

Donating Your vehicle?

Yes, I want to donate my vehicle to ALS Hope Foundation.

Vehicle Information Section

Year * Make *
Model * Mileage
Licence Plate VIN #
 If your vehicle is located at a different address from your home address, please check the box and then complete the following section, if same as home address (skip)
Condition of vehicle Comments about vehicle
I do have the ownership / title to transfer to the Authorized Treatment Facility.

Vehicle Images Section
Uploading images will help us to better determine the value of your vehicle, possibly increasing what we will pay for your car.

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