Donation & Pick-Up Acknowledgement Form

Once you complete & submit this form a volunteer will call you to schedule the pick up or drop off within a few days (Please do not call the office). Please Note: We do not service Surrey, Delta, Langley, Pitt Meadows, Maple Ridge or beyond.

Name*

First Last

Phone*

Email*

Address*

Street Address City Province

Household Items

Please Confirm*

That you have read the following list

kitchen tables and chairs
dining room tables & chairs
bookcases
coffee tables
small desks
dressers
beds
sofas
dishes
pots and pans
towels
chairs
bedding
clothing and morev
Electronics (VCR/DVD players, microwaves and computers) in good working condition
PLEASE NOTE: We do NOT accept China Buffets or Entertainment Centers

Please list the items you would like to donate:*

Column 1	Column 2	Column 3

Use the "+" button to add as many rows as you need.

We no longer accept donations of headboards/footboards, curio cabinets, china cupboards/cabinets/buffets or mirrors. We require images of ALL furniture items being donated. Do you have photos of your items?*

Yes

We require images of ALL furniture items being donated.*

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 22 MB, Max. files: 15.

If you have upholstered furniture ie: sofas, love seats, chairs or other large furniture pieces, please upload photos so we can be sure that these are something that we can pass along to a family. We no longer accept donations of headboards/footboards, curio cabinets, china cupboards/cabinets/buffets or mirrors. Image files types accepted: jpg, png, gif, pdf, max file size 20mb

Consent*

Acknowledgment of household goods and monetary donation

I acknowledge that I have read the criteria listed on the household items we accept page and that my donation meets the Helping Families in Need criteria for donation including that you are prepared to make a minimum $100 donation (depending on the distance travelled, number of items being donated) on a pick up.

Helping Families

Household Items

ACKNOWLEDGMENT

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