Contact form - To donate items such as books, school, office supplies, Kindle / eReader, etc.

Your Contact Information

First Name

Last Name

Phone

Address

Address 2 (Suite, Apt.)

City/Town

State/Province

ZIP/Postal Code

Country

Send me text messages at the above number

I am submitting this form as an/a

Individual

Group

Business / Organization

What will you be sending (books, school supplies, pencils etc)?

When do you plan to ship the items?

I / we are planning to donate the following amount to help cover shipping to Africa

Background Information

Please tell us a bit about yourself or your group

Name of group (if doing this as a group)

Number of people in group (if doing this as a group)

My group has been formed under / is affiliated with / is part of (school / college / university / church / organization etc. - if doing this as a group)

Comments / Questions

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Math question 3 + 1 =

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