SOQUEL SPORTS FOUNDATION - Vehicle Donation Form
DONOR INFORMATION
Donor Name: *
Address: *
E-mail: *
Daytime Phone: *
Alternate Phone: *
City: *
State: *	AL AK AR AZ CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Zip code: *
Date:
VEHICLE INFORMATION
Is vehicle at above address? *	No Yes
If no, please confirm location: (include address, city, state, etc):
Year of Vehicle *
Make / Model: *
License Plate # *
Vehichle Identification Number (VIN): *
Please check all that apply: *	2-Door 4-Door 4-Wheel Drive Station Wagon
Does the vehicle run and drive as is? *	No Yes
If No, explain:
Do you have the Title? *	No Yes
If No, explain:
Please note any problems/damage to: Engine, Transmission, Tires, Body, Other: *
Please re-type what is displayed here: *