Donation Form
Important Information
Please use the same
first name
,
last name
and
email
in all your current and future engagements with LifeMoves.
Contact Information
Select your donation type
Individual Donation
Group/Business Donation
1st Time Donation
Date
Name
Company/Organization
Organization Type
Please select...
Company
Faith-Based Organization
School
Social/Service group
Salutation
Mr.
Mrs.
Ms.
Other
Other
Address
City
State
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Zip
Email
Email Type
Personal
Work
Alternate
Phone
Phone Type
Home
Cell
Work
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Drop-off Location
Please Select the LifeMoves Location where you will drop off your donation
Administrative Office
Georgia Travis House
Family Crossroads
First Step for Families
Haven Family House
Julian Street Inn
Maple Street
Montgomery Street Inn
Opportunity Services Center
Redwood Family House
Vendome
Villa
Other
Other
Pick-Up Location
Please Select the LifeMoves Location where you will pick up your donation
Administrative Office
Georgia Travis House
Family Crossroads
First Step for Families
Haven Family House
Julian Street Inn
Maple Street
Montgomery Street Inn
Opportunity Services Center
Redwood Family House
Vendome
Villa
Other
Other
Donation Information
Items Donated
Automobile
Clothing
Computers/Electronics
Food
Furniture
Gift Cards
Household Goods
Prepared Meals
Professional Services
Donor Estimated Value of In-Kind Gifts
Value of Gift Cards Received
Other Cash Gifts Received
Food Donations
Number of Meals
Pounds of Food
Meal
Please select...
Breakfast
Lunch
Dinner
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Contact Information
Donation Form