Technology Equipment Donation Request
Requestor Name:
First Name
Last Name
Requestor Email:
example@example.org
Phone Number:
-
Area Code
Phone Number
Drop off Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of your CEO or Executive Director:
First Name
Last Name
Email of your CEO or Executive Director:
example@example.org
What is your Organization's mission statement:
How will this donation be used by your organization:
At what location will you be using this equipment?
Please list how much equipment you need:
Requested amount
Desktop computer
Monitor
Laptop
Tablet
Please attach your organization's W-9:
Browse Files
Cancel
of
Please attach your organization's 501c3 designation letter:
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Cancel
of
Submit
Should be Empty: