Donate a Car to
Leukemia & Lymphoma Society of Canada
Donor's Information Tax receipt will be issued to the name listed in this section Name must match the vehicle registration |
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First Name (or Company Name) |
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Last Name | |
Street Address | |
City or Town | |
Province | |
Postal Code | |
Phone | |
Phone Other | |
Email Address | |
Confirm Email Address |
Vehicle Information |
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Year (4 digits) | |||
Make | |||
Model | |||
Color | |||
Serial Number (17 characters) |
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Odometer | |||
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Please Select One: | |||
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What chapter would you like to donate your vehicle to? |