Donations

Name: Enter Name

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Email: Enter Email

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Address: Enter Address

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City: Enter City

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State: Enter State

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Zip code: Enter Zip

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Phone: Enter Phone Number

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Vehicle Current Address: Enter Text

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Vehicle Current City: Enter Text

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Vehicle Current State and Zip: Enter Text

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Year of Vehicle: Enter Text

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Make of Vehicle: Enter Text

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Model of Vehicle: Enter Text

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Mileage: Enter Text

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License Plate and VIN: Enter Your Message

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Damage to Body and Interior (Describle): Enter Your Message

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Is the Vehicle Drivable? : Enter Your Message

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Do you have Title? If not, explain: Enter Your Message

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Special Instructions or Comments: Enter Your Message

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CAR DONATION FORM

Please use this form to donate your car. If you have any questions you would like answered previous to initiating the donation process, please feel free to email or call 631-470-1198 (Monday thru Friday 9am - 5pm est).

Name: Enter Name

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Email: Enter Email

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Address: Enter Address

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City: Enter City

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State: Enter State

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Zip code: Enter Zip

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Phone: Enter Phone Number

Required

Boat Current Address: Enter Text

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Boat Current City: Enter Text

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Boat Current State and Zip: Enter Text

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Year of Boat: Enter Text

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Make of Boat: Enter Text

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Model of Boat: Enter Text

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Size of Boat: Enter Text

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Boat Type: Enter Your Message

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Engine Size: Enter Your Message

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Boat VIN: Enter Your Message

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Condition of Boat: Enter Your Message

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Is Trailer Included:

Required

Yes

Boat Title:

Required

Yes

Title for Trailer:

Required

Yes

If Yes, Trailer VIN: Enter Text

Required

BOAT DONATION FORM

Please use this form to donate your boat. If you have any questions you would like answered previous to initiating the donation process, please feel free to email or call 631-470-1198 (Monday thru Friday 9am - 5pm est).

Name: Enter Name

Required

Email: Enter Email

Required

Address: Enter Address

Required

City: Enter City

Required

State: Enter State

Required

Zip code: Enter Zip

Required

Submitting Form...

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Form received.

Phone: Enter Phone Number

Required

Vehicle Current Address: Enter Text

Required

Vehicle Current City: Enter Text

Required

Vehicle Current State and Zip: Enter Text

Required

Year of Vehicle: Enter Text

Required

Make of Vehicle: Enter Text

Required

Model of Vehicle: Enter Text

Required

Mileage: Enter Text

Required

License Plate and VIN: Enter Your Message

Required

Damage to Body and Interior (Describle): Enter Your Message

Required

Is the Vehicle Drivable? : Enter Your Message

Required

Do you have Title? If not, explain: Enter Your Message

Required

Special Instructions or Comments: Enter Your Message

Required

VANS, TRUCKS & RV DONATION FORM

Please use this form to donate your Van, Truck or RV. If you have any questions you would like answered previous to initiating the donation process, please feel free to email or call 631-470-1198 (Monday thru Friday 9am - 5pm est).

CAR DONATIONS

Click Here For Donation Form

BOAT DONATIONS

Click Here For Donation Form

VANS, TRUCKS, RVS

Click Here For Donation Form

ABOUT US

Have a Heart Children's Cancer Society was formed for the sole purpose of improving the quality of life for these courageous children and their families. Our team is dedicated to collaborating with hospitals, medical centers and other children's organizations to locate families who have financially fallen prey to this debilitating disease. Once identified, we are able to assist them with medical bills, treatments, equipment, transportation and household expenses.

MORE INFORMATION

HAVE A HEART is a Non-Profit Charity 501(C)3

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