Ozanam Donation Pickup Request

	We will not share your information with anyone.
	Address:
	Suite/Apt. No.
	City:
	State:
	Did you receive a postcard in the mail?	Yes No
	Please enter the pickup date printed on the postcard. If you no longer have the card, please skip this question.
	Zip Code:	Just the first 5 digits please.
	Our next pickup in your area will be:	Please fill out above entries completely for schedule information.