Walk-In Donation Form

Who are you, in relation to these items you're donating?

I own these items.

I'm filling this form out on behalf of a business or someone who owns these items.

These items belong to…

a business.

an individual.

Your First Name

Your Last Name

Your Contact Phone

Your Email Address

Business Name

Donor's First Name

Donor's Last Name

Donor's Phone Number

Donor's Email Address

Your Mailing Address

City

State/Province

Zip/Postal

Donor's Mailing Address

City

State/Province

Zip/Postal

List of Donated Items

How did you hear about us?

Tell us more about where you heard about us.

An e-mail will be sent to you as confirmation.

By submitting this form, the donor certifies that they did not receive any goods or services in exchange for their donation.

If you experience any issues with this form, please seek assistance from a store representative.

Contributions of goods are tax-deductible for income tax purposes to the extent allowed by law. Second Chance, Inc. does not place a valuation on your gift. That is the privilege and responsibility of the donor. Please consult your tax advisor for all relevant details.

If you are human, leave this field blank.