Wreaths Across America: Trucking Donation Form

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* 1. Company Information

Company Name: *

Address: *

Address 2:

City/Town: *

State: *

ZIP: *

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* 2. Head of Company / Top Decision-Maker Information

Name:

E-mail Address:

Phone Number:

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* 3. Company Dispatcher / Contact Person

Name:

E-mail Address:

Phone Number:

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* 4. Donation Information

How many dry van trucks will you volunteer?

What size?

How many reefer trucks will you volunteer?

What size?

How many days can you commit each truck for?

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* 5. Can you pick up in Maine?

Yes

No

If No, where can you pick up?

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* 6. What lane(s) and/or delivery area(s) do you prefer?

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* 7. Do you have any special instructions or requests?