Name *

First Name

Last Name

Phone *

(###)

###

####

I agree that all furniture must be on the main level or in the garage. The furniture must be ready for The Mustard Seed Team upon arrival. *

Choose One Option

Yes - I agree with the statements above

Yes - I agree with the statements above, but I am a Senior Citizen and I will need assistance

No - I understand that The Mustard Seed Team WILL NOT be able to pick up my furniture

What are you requesting? *

Furniture-Pick-Up (Can take up to 2 weeks)

Furniture Drop-off (Anytime M-Th from 10am-4pm)

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are your items free of rips, tears, stains, and free of health risks including rodents and bugs? Your mattress must be in good/gently used condition for us to pick up. *

Yes

No

I understand that at the time of arrival that The Mustard Seed Team are not movers and we have the option to not take the furniture items on-site due to stains, tears, or quality. *

Yes

No

Monetary Donation *

Donate by check or Paypal only. Please note that both your in-kind and monetary donations are tax-deductible.

$50: contributes toward the transportation, storage, and delivery of the items to the community in need within 10 miles of TMS

$75: contributes toward the transportation, storage, and delivery of the items to the community in need within 11-15 miles of TMS

$100 contributes toward the transportation, storage, and delivery of the items to the community in need within 16-20 miles of TMS

$125 contributes toward the transportation, storage, and delivery of the items to the community in need within 20-25 miles of TMS

I am outside of the 25 mile range (We are unable to pick up but furniture can be dropped off)

I plan to drop off (no monetary donation requested)