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Vehicle Donation Form
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Bidder Request details
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Registration Request Status
Submitted
Approved
Rejected
Duplicate
Auction
Email / Correo Electronico
First Name / Primer Nombre
*
Last Name / Apellido
*
Date of Birth / Fecha de Nacimiento
*
Bidder Detail
Select Existing (Approved) Bidder Record
Approved Bidder Record
Link to the Approved Bidder/Buyer Record
Mailing Address / Direccion De Envio
*
City / Ciudad
*
State / Estado
*
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
Zip / Codigo Postal
*
Cell Phone / Telephono Movil
*
Enter the Cell Phone number, starting with area code, digits only, no () or -
Check box to opt In to receive texts
Opt In for Text Messages / Optar para recibir mensajes de texto
Other Phone / Segundo Numero de Telephono
Payment Appointment: Winning Bidders Only
*
Mon 10:00-12:00
Mon 12:00-2:00
Mon 2:00-4:00
How Did You Hear About Give Hope a Ride? / Como Escuchaste de Give Hope a Ride ?
Previous Bidder
Previous Donor
Radio
Family/Friend
Casa Guest
TV
Online
Partner Charity
Billboard
Unknown
Other
Driver's License State AND Number (ex: NM 554785) / Numero de Licencia de Conducir y El Estado
*
Drivers License Expiration Date
REQUIRED: Upload a picture of your current driver's license / NECESARIO: Sube una foto de su licencia de conducir
Maximum file size allowed: 101024 KB.
Allowed file types: jpg, jpeg, gif, png
Upload new file
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Flag if this is a Company record
Company Indicator
Company Affiliation (ex: Joe's Body Shop) / Nombre de Empresa
Notes
Create Date
Date the Buyer record is added
Created By
Update Date
Updated By
User that last updated this record
ID
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