Become a Collection Site - Little Smiles Florida

Become a Collection Site 2024

Company, School or Organization (if applicable)(Required)

Number of Boxes Requested:(Required)

Name(Required)

First Name Last Name

Street Address(Required)

Street Address Address Line 2 City ZIP Code

Email(Required)

Preferred Phone Number(Required)

Are you able to pick up boxes from the Little Smiles office in Palm Beach Gardens?(Required)

If your boxes need to be delivered, what is your preferred box drop off date? (This does not guarantee box drop off by the selected date)(Required)

Boxes will be scheduled for pickup between 12/9-12/19, what is your preferred box pickup date? This does not guarantee box pick up by the selected date(Required)

Can we contact you before the pick up date to do a partial pick up?(Required)

Are you associated with the Marine Industries Association of Palm Beach County?(Required)

This Donation Box Will Be(Required)

If open to the public, what days/times can people stop by?(Required)

Can your collection site be listed on our website?(Required)

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Name

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