AADAP, Inc. COVID-19 Related Donation Survey

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* 1. If you would like to make a donation, please fill out this form. Thank you for your generosity. Please begin by providing your contact information.

Name *

Company

Address

City/Town

State/Province

ZIP/Postal Code

Country

Email Address *

Phone Number *

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* 2. Please describe in detail what you would like to donate to AADAP. Please answer in particular the following questions:

General description of item?

Are the packages open/unopened?

Number of items?

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* 3. Are you able to deliver or ship the donation directly to the AADAP Corporate Office at 2900 Crenshaw Blvd., Los Angeles, CA 90016? Delivery is possible from 9 a.m. to 6 p.m., Monday-Friday.

Yes

No

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* 4. Please provide anticipated date of delivery at AADAP.

Date / Time

Date

Time

AM/PM

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* 5. We strongly prefer (and would appreciate it) if you could deliver the items to AADAP. However, if you cannot, please send Dean Nakanishi an email at dnakanishi@aadapinc.org, with the size and nature of the donation, and your location, and we will determine whether we are able to pick it up.

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* 6. We are in need of volunteers to make masks, and have t-shirts that can be reclaimed as materials. If you are interested in this please check yes below.

Yes

No

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* 7. Please provide any additional details or information that you feel important for us to know about your donation. Thank you very much!