Early Alert Canines

Contact Information

Concord

California

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The mission of Early Alert Canines is to improve the health, safety, and well-being of insulin-dependent diabetics through partnerships with certified low blood sugar alert dogs. We train and provide medical alert assistance dogs to insulin-dependent diabetics who need them.

Donate a Car to Charity

Please fill out the form below to donate a car!

Name*
Prefix First Middle Last Suffix
Email*

Phone*
Work Phone
Cell Phone
Address*
Street Address City State ZIP Code

Business Name

Business Phone
Vehicle Year*
Vehicle Make*

Vehicle Model*

Vehicle Color*

Numer of Doors
Current Mileage*

Registration*

Yes

No
State Vehicle Registered
State

Registration Expiration Date*
MM slash DD slash YYYY

Why don't you have the Registratrion?
Do You Have the Certificate of Title (Pink Slip)?*

Yes

No
Is the Vehicle in Running Condition?*
Why don't you have the Pink Slip?
Why isn't the Vehicle in Running Condition?
Vehicle Identification Number*

License Plate Number

Describe Mechanical Issues, if any
Describe Condition of Body
Describe Condition of Paint
Describe Condition of Interior
To Which Charity Would You Like to Donate Your Vehicle?*
Is the Vehicle Located at the Address Above?*

Yes

No
How did you hear about our car donation program?*

Notate the address where the vehicle is located
Street Address City State ZIP Code

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