Technology Donation Inquiry Form
For Group Home Alliance's AI for Seniors program. Businesses, government agencies, schools, and organizations upgrading equipment are encouraged to contact us regarding bulk technology donations.
Contact Information
Full Name
*
First Name
Last Name
Organization Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
City
*
State
*
Donation Information
What technology types are you donating?
*
Laptop
Tablet
Smartphone
Desktop Computer
Monitor
Printer
Projector
Smart Speaker
Keyboard
Mouse
Webcam
Networking Equipment
Other Technology Equipment
If Other, please describe:
How many items are you donating?
*
Please Select
1
2–5
6–10
11–25
25+
Equipment condition
*
New
Like New
Good Working Condition
Fair Working Condition
Needs Minor Repair
Unsure
Approximate equipment age
Please Select
Less than 1 Year
1–3 Years
3–5 Years
More than 5 Years
Unsure
Upload photos of the equipment
Upload a File
Drag and drop files here
Choose a file
Cancel
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Donation Logistics
Preferred donation method
*
I can drop off the equipment
I would like to discuss pickup options
I am not sure yet
Additional information about the equipment
Tax Receipt Information
Will you need a donation acknowledgment letter or receipt for tax purposes?
*
Yes
No
Unsure
Name to appear on the acknowledgment letter
Who is making the donation?
*
An Individual
A Business
A Nonprofit Organization
A Government Agency
Other
Estimated Fair Market Value of Donation
Group Home Alliance cannot determine the value of donated items. Donors are responsible for determining the fair market value of their donation for tax purposes.
Donate Technology
Should be Empty: