DSEP Application for Laptop

Laptop Access Program
Application Form
DSEP will sell new and fairly used laptops to eligible trainees at discounted rates. Trainees can pay in installments.
Name*

First NameLast Name
Email*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Date of birth*

MonthDayYear
Date
Why do you need a laptop or cellphone?*
Upload your ID Card (NIN/Voter's Card/Driver's license/International Passport)*

NInc, Drivers license, Voters card, International Passport
Cancelof

GUARANTOR INFORMATION
Guarantor Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Guarantor Occupation*
Relationship with Applicant*
Upload Guarantor ID Card (NIN/Voter's Card/Driver's license/International Passport)*

NInc, Drivers license, Voters card, International Passport
Cancelof
Should be Empty:

Laptop Access Program