Home Frequently Asked Questions About Us Donation Form American Lung Association of Rhode Island

Donation Form* Thank you for choosing to donate to us. Please use the following form to donate your car, boat, RV or other qualifying vehicle. We will contact you via phone or email within four business days to complete your donation request and coordinate the pickup of your donated vehicle. If you have any questions at anytime during the donation process, please email us at [email protected]. If you prefer to speak with someone by phone, please contact our knowledgeable customer service staff at 1-800-577-LUNG. Vehicle Donation Personal Information click here for help Title* Select one Mr. Ms. Mrs. Mr. & Mrs. Miss Adm Aldrmn Atty Bishop Brother Cadet Capt Chapln Chief Cmdr CMSGT Col. Col. & Mr. Col. & Mrs. Dr. Dr. & Mr. Dr. & Mrs. Ensign Father Gen. Gen. & Mr. Gen. & Mrs. Gov. Hon. Judge Lady Lt Cmd/Dr Lt CMD/Mr. Lt. Lt. & Mr. Lt. & Mrs. Lt. CMD. Lt. Gen. Lt.Col. LtCol & Mrs. Maj & Mrs. Maj. Maj. & Mr. Master Mayor Monsgn Mother Msgr MSGT Msgt Nurse Pastor Pastor & Mrs. Pfc Pres. Prof. R. Adm. Rabbi Rep. Rev. Rev. & Dr. Rev. & Mr. Rev. & Mrs Rev. Mr. Rn Seaman Sen. Sgt SGT.MAJ. Sister SSGT TSGT First name* Last name* Suffix Select one BA BS BSN CPA CRT DMD DC DDS DO DR DS DVM Esq LPN MA MBA MD MEd MD MPH MS, RD NP OD OHN PE PGm PASTOR PE PhD PNP RD RET RN RPH RPN RRT USAF Ret USN Ret XVI Sr Suffix Select one II III IV Jr. Sr. Business name Address type* Home Business Non USA Address1* Address2 City* State* Select one Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas U.S. Virgin Islands Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip* Zip2 Home Phone* - - Bus Phone - -  Ext   Fax - - Email* Vehicle information Type* Select one Vehicle Boat Make* Select one Acura Alfa Romeo Audi BMW Buick Cadillac Chevrolet Chrysler Daewoo Daihatsu Dodge Eagle Ford Geo GMC Honda Hyundai Infiniti Isuzu Jaguar Jeep Land Rover Lexus Lincoln Mazda Mercedes-Benz Mercury Mitsubishi Nissan Oldsmobile Peugeot Plymouth Pontiac Porsche Saab Saturn Sterling Subaru Suzuki Toyota Volkswagen Volvo Yugo Other Model* Select one Other Model Year*  (4 digit year) # of Doors* Select one 1 Door 2 Door 3 Door 4 Door 5 Door Unknown Is it road worthy?* NoYes Approximate Mileage* VIN #* Any major damage?* NoYes  If yes, description Location for pick up* use same address Is the Title Free?* NoYes Lien Holder? Yes  If yes, lien released Plates  Plate # Current Registration?*  If not, last registered Weight Comments

 

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