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Complete the form below and Mail to:
The American Pan-African Relief Agencies, Inc.
P.O. Box 723, Williams bridge  Station 
Bronx, New York City, New York 10467

Non-Financial Donation Form

The American Pan-African Relief Agencies also accepts and appreciates non-financial donations, such as non-perishable foods, pharmaceutical products and supplies for AIDS Orphans/Distressed Children HIV/AIDS, hospital and medical supplies and equipment, educational supplies and equipment including new and used computers, new and used vehicles and general relief materials.

Please complete this form and mail to the above address. Completed form can also be faxed to 646-853-3393 or email to info@apara.org


Name: ___________________________________________________________________

Address:__________________________________________________________________

City____________________ State::_________________ Zip Code:__________

Telephone:_________________________ Fax:__________________________

E-Mail:_________________________________________

Please indicate the type of donation:

(a) Food    (b) Other Merchandise Donations
(c)
General Medical Donations - such as Medical & Education Supplies, HIV/AIDS Medication, Other Pharmaceutical Products

Description of Food to be donated:_____________________________________________
________________________________________________________________________

Description of other products in (b) and (c) above, to be donated:______________________
________________________________________________________________________
________________________________________________________________________ 

Quantity:_______________ Type of packaging:________________________

Terms of Delivery:__________________________________________________________

New or Used vehicles – please give full details; particulars and quantity: _______________
________________________________________________________________________
________________________________________________________________________