Tampa Bay Non-Profit Transportation Service

VEHICLE DONATION APPLICATION

Please use the form below to donate your vehicle to Wheels of Success. We will contact you within five business days after submission. If you have any questions about the donation process, please contact us.

(fields in red are required)

Donor Information
First Name:
Last Name:
Address:
City:
State
ZIP
Phone Number:
Alternate Phone:
Email:

Vehicle Location
Address:
City:
State:
ZIP:
Nearest major intersection:

Vehicle Information
Year:
Make:
Model:
Color:
Automatic/Stick?
VIN:
Mileage:
Clear Title?
# of Key Sets?

What is wrong with the vehicle? Wheels of Success will take all vehicles. Please let us know what is wrong with your vehicle so we can schedule repairs.
Damage to Body:	(Describe)
Damage to Interior:	(Describe)
Does the Vehicle Run:	(Describe)
Additional Concerns:	(Describe)
Do you have the Certificate of Title?
Pick Up Address:
Cross Streets:
How Did You Hear About Us?
Additional Comments:
Wheels of Success, Inc. reserves the right to determine the disposition of the vehicle based on our certified mechanics recommendation.

Wheels of Success is Tampa Bay's only 501(c)3 nonprofit organization providing a full range of transportation solutions, including vehicle replacement; car repair; and licensing, car payment and down payment assistance to low and moderate income working families.

Site designed and maintained by South Island Design