EQUIPMENT RETURN/ DONATION FORM
PRINT THIS FORM WHEN COMPLETED. IT IS YOUR TAX RECEIPT.

The Pluckemin Medical Equipment Ministry is dedicated to improving the lives of our clients and their families through the redistribution of used medical equipment and supplies, at no cost to them.  Your donations are are desperately needed.

MEDICAL EQUIPMENT CAN BE DONATED ON THURSDAY'S 9 am - 4 pm ( Staff do not arrive until 1PM) and SATURDAY'S 8am -10 am in the designated area marked in the photo below. NO APPOINTMENTS NECESSARY.

On Thursday's Please DO NOT return/donate when there is pending inclement weather as your return/donation will become ruined and be discarded. Staff do not arrive until 1 pm to collect the returns/donations.  

Please return/donate equipment ONLY in the designated area, and only on designated days. There is a preschool on our property and random donations of medical equipment left in undesignated areas or on days other than DONATION DAYS, puts the children and others at risk.
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Email *
Phone Number *
Last Name: *
First Name: *
Please check off EACH of the following boxes to indicate your acknowledgement: *
Required
Which day will you be returning/donating medical equipment? *
YOUR DONATION RECEIPT                                                                                                                                                                           The following section will serve as your receipt and will be emailed to you upon submission of this form.  Pluckemin Presbyterian Church is a 501(c)(3) non-profit organization. The donor did not receive any remuneration for donated items. Thank you again for your contribution, which will directly benefit those in our community! Please check off all items that were donated.
I am returning/donating the following items to Pluckemin Medical Equipment Ministry. The following items are clean and in good condition. I am returning/donating equipment that I would feel comfortable receiving. *
Required
If you donated diapers, bed pads, or other items in bulk, please indicate the number below:
If you checked other, please tells us what you are donating.
Pluckemin Church Medical Equipment Ministry 🔵 279 US 202 Pluckemin NJ  07978 🔵 www.ppcmem.org 
Equipment Return/Drop Off Location
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