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ReStore Donation Pickup Request
"
*
" indicates required fields
Todays Date
*
MM slash DD slash YYYY
First Name
*
Last Name
*
Phone Number (including area code)
*
Email Address
*
Pickup Address
*
Street Address
City
ZIP Code
Gate Code (if needed)
Specific directions beyond what GPS instructs (if needed):
Do you want to receive a letter from the ReStore for your tax purposes? ( YES / NO ) *
*
Yes
No
Mailing Address if different than Pickup Address:
Street Address
City
ZIP Code
Driver will call to confirm a pickup date and approximate time.
List of Item’s to be picked up:
*
Name
This field is for validation purposes and should be left unchanged.
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