Name *

First Name

Last Name

Phone *

(###)

###

####

Donation Source *

Are you an individual, company or organization donating equipment?

Company/Organization

Individual

Other

Let us know how you plan to help

Please check each option that describes how you plan to help us obtain and/or distribute devices.

I Have a collection of laptops and tablets to donate

I will collect laptops and tablets from members of my organization

I can become a laptop redistribution location