Apply

Subject

Name of your Organization (required)

Your Name (required)

Your Title (required)

Your Email (required)

Your Telephone Number (required)

Are you a 501c(3) non-profit? (required)

Your Website URL (if you have one)

Select Needed Hardware (required)
Desktop(s)Laptop(s)Mac(s)Monitor(s)SwitchesFirewall(s)Access PointsOther (Please specify below)

Other

Do you have the means to setup the hardware once donated?

If yes, please explain how you will accomplish this

Details (please be as specific as possible) (required)

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