CONSIDER DONATING YOUR VEHICLE!
It’s easier than selling it yourself, AND your tax savings might even be more than what you would receive from a trade-in!

Looking at replacing your car, truck, boat or RV but not sure what to do with the old one? Or, did you keep your old vehicle because you had lots of space but now you’d like to make room? Donate your used vehicle to the National Fibromyalgia Research Association and we’ll arrange to have it picked up free of charge. Working with Car Program Inc., we’re able to accept most vehicles, even if they don’t run. Some restrictions may apply on older vehicles, and in some locations.

It’s easy. Just fill out the form below and send it to us by e-mail. You’ll be contacted by a representative from Car Program Inc. within 4 working days to determine if your vehicle is eligible and to schedule pick up. Have questions? Most of your questions will be covered in our Frequently Asked Questions. If you have more questions, please contact us by e-mail at nfra@nfra.net or call at 503-315-7257.

  • Please complete and fax this form to NFRA at 503-315-7205
  • Or, if you prefer, you may complete this form and eamil to us at nfra@nfra.net
  • You will be contacted within four business days by a representative from Car Program Inc.
  • Thank you for your support

Date: Donor Name:

Mailing Address:

City: State: Zip:

Phone #: Alternate #:

Vehicle Location:

City: State: Zip:

VEHICLE INFORMATION:

Year: Make: Model:

VIN: License #:

Please check all that apply: 2-Door 4-Door Station Wagon 4-Wheel Drive

Does the vehicle run and drive as is? Yes No, Explain:

Do you have the title: Yes No, explain:

PLEASE NOTE ANY PROBLEMS/DAMAGE:

Engine:

Trans:

Tires:

Body:

Other:

SPECIAL INSTRUCTIONS:

PLEASE print a copy of this for your records before you submit. Print from the printer icon on your web browser..

503-315-7257 * 503-315-7205 fax

nfra@nfra.net * www.nfra.net

P.O. Box 500 * Salem, Oregon 97308