This form is to be completed by the referring agency/organization, business, or individual for qualifying charitable organizations in need of domestic transportation services.
Referrals will be considered and interviewed before confirmation of acceptance. The referred organization must be involved in the business of helping needy families by
providing food, clothing or medical supplies at low or no cost, and preferably provide employment and vocational or educational opportunities.
When referring an organization or individual for domestic donated transportation services please make certain that you possess pertinent information about their organization before making the referral.