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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.

Your use of this website is governed by our Terms of Use.

1Organization Details

2Transportation Department Information

3Billing Information

Organization Name(Required)

Mission(Required)

Describe your organization's mission in two to three sentences. This description will appear by your organization's "Donate Now" button when someone enters a zip code covered by your pick up area.

Enter your transportation department and stores:
The transportation department for your organization is the contact person responsible for coordinating pick ups in a given area.

Associated with your transportation department will be a list of stores and zip codes. The zip codes are the areas where you are WILLING to to provide pick ups. The stores are the locations closest to those areas where a donor could drop off their items if they are too small or do not meet pick up criteria.

This form lets you submit one transportation department and ten stores. If you need to submit more transportation departments and stores, complete this form, including what you can. Then email us at signup@pickupmydonation.com, and we will send you a spreadsheet to fill out with all of your data.

Transportation Department

Please provide information about the department and designated agent responsible for scheduling donations.

Department Name(Required)

What you call the dispatch department. (e.g. Logistics, Transportation, etc).

Contact Title(Required)

Title of the person who manages this department (e.g. Logistics Coordinator).

Name(Required)

First Last

Email(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Website

Zip Codes(Required)

Enter a comma separated lists of zip codes associated with this transportation department (e.g. 12345, 12344, 12355).

Transportation Department Stores

Please provide the store location(s) where a donor can be referred to drop off their donation in the event that it does NOT meet YOUR pick up criteria.

Store Name	Store Address	Actions
		Edit Delete
There are no Stores.

Maximum number of stores reached.

Name(Required)

First Last

Organization Name(Required)

Email(Required)

Phone(Required)

Payment Method(Required)

Pay by Credit Card

I don't have a credit card.

Credit Card

Card Details

Cardholder Name

Bank Draft Payment Information

For pickup providers without a credit card, we offer payment via a monthly bank draft. To setup your payment, please provide your account details below:

Name on Account(Required)

ABA Routing Number(Required)

Account Number(Required)

Bank Account Type(Required)

Checking

Savings

Business Checking

Name of Bank(Required)

Exclusive Market License(Required)

Price:

Monthly Recurring Subtotal

$0.00

Coupon Code

Today's Total