Kidney Car Donation Form - Ontario

Kidney Car Donation Form
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Please complete the form below and our friendly dispatcher will contact you within 24hrs.

Have a question? We have the answer in our FAQ or email us at kidneycar@kidney.ca.
Tax Receipt Information
Tax Receipt Information - Business
How would you like to receive your tax receipt? *This question is required.
Pick up Information
How can we contact you?
Tell us about your vehicle
How did you hear about Kidney Car? (please check all that apply)
By entering a promo code I acknowledge that my name and Kidney Car donation confirmation number will be confirmed with promotion sponsors to qualify me for program incentives.
Information for the "In Memoriam" card
Information for the "In Honour" card