MJAA: Survey - Goods Donation Form


	Question - Not Required - Organization/Company
*	Question - Required - Contact Name
*	Question - Required - Phone Number
	Question - Not Required - Email
	Question - Not Required - Fax
	Question - Not Required - Mailing Address (Maximum response 255 chars, approx. 5 rows of text)
	Question - Not Required - Items (Maximum response 255 chars, approx. 5 rows of text)
	Question - Not Required - Estimated Value
	Question - Not Required - Palletized?
	Question - Not Required - Can you transport to our staging center?
	Question - Not Required - If yes, which center?
	Question - Not Required - Can you pay shipping costs?
	Question - Not Required - Additional Questions (Maximum response 255 chars, approx. 5 rows of text)