National Greyhound Adoption Program
10901 Dutton Rd.
Phila, PA 19154
USA
Telephone: 800-348-2517 or 215-331-7918
FAX: 215-331-1947

NGAP E-mail: ngap@ix.netcom.com

CAR DONATION FORM                                                                        Date_________

How did you hear about us?  Billboard__  Phila. Inquirer___(Date)___________  Did you cut the article out and hold it?  Yes____  No____  Other________________________________________

Why did you select NGAP?___________________________________________________

Name of Donor______________________________________________________________

Address____________________________________________________________________

City ____________________________State __________Zip__________

Home # (____)__________________Work #(____)______________________

Year___________  Make__________________  Model______________________________

2 Door____  4 Door____  Color_______________  Mileage_____________

Does it run?  Yes____  No____  If no, why?_______________________________________         

Does it need a battery?  Yes_____   No_____

If it had a battery, would it run?  Yes_____    No____

Do you have the keys?  Yes____  No____ (If No, then a cash donation of $100.00 is required)

Is the car automatic _____ or stick shift?_____ (Check one)

Condition Overall:  Poor_____   Fair_____  Good_____  Excellent______

Body condition:  Poor____  Fair____  Good____  Excellent____

Is there any body damage? (Explain)_____________________________________________

Is there any interior damage? (Explain)_______________________________________________

Engine Condition:   Poor____  Fair____  Good____  Excellent____

Transmission:  Poor____  Fair____  Good____  Excellent____

Tires:  Poor____  Fair____  Good____  Excellent____

Vin#____________________________________________________________

Do you have the title?  Yes____    No____

Is the title in your name?  Yes____  No___  If No, who’s name._________________________ 

Current inspection?  Yes____  No____

Directions for pickup___________________________________________________________

_____________________________________________________________________________

T-shirt size (please indicate)  Med____  Lg____  XL____  XXL____

****Please note:  Title Must Be Notarized****