Fee Based Priority Provider Sign Up

Signup for PickUpMyDonation.com by completing this form. Please see our Partner Organizations page for our Description of Services and Return, Refund and Cancellation Policies.

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Company Name*
Contact Name*
First Last
Company Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Company Phone*
Contact Email*
Pick Up Zip Codes*
Please provide a comma separated list of all zip codes where you provide pick ups.
Your Organization's Description
Whenever your organization shows up in our system via a zip code query, we'll show the following description:
Priority Donation Pickups (Fee Based): This priority service is provided by (YOUR COMPANY NAME HERE) which charges a fee for their pickup service, but includes additional benefits such as the removal of items from anywhere inside your property to be taken to a local non-profit, as well as the removal of junk and items local non-profits cannot accept. Price estimates are given up-front on site. Donors receive a 5% discount off the regular pricing of (COMPANY NAME HERE), and all sellable donations will be delivered to a NON-PROFIT.
If you would like to edit the description for your company, email us at contact@pickupmydonation.com.
Credit Card*
American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Credit Card Billing Address*
Same as Company Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Fee Based Provider Monthly Subscription
Price: $200.00
Coupon Code
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Recurring Monthly Amount
$0.00