Computers for Schools-NWT

COMPUTER DONATION FORM

If you have PC’s to donate to the Computers for Schools program, please fill the following form out in full.

Contact Name: ____________________ Company Name: __________________________________

Address: __________________________________________________________________________

City: _________________________ Prov. /Terr: ____________ Postal Code: ________________

Phone# :( ) ___________ Fax# :( ) ___________ Email: ______________________________

Please choose the city/town, which you are closest to:

Yellowknife Inuvik ‘ Hay River ‘ Fort Smith ‘ Fort Resolution

‘ Other _____________________

Have you ever donated to Computers for Schools before? ’ Yes “ No

What equipment would you like to donate?

“ Pentium Class Computers (P4 or higher) “ Monitors (15” LCD or Higher)

“ Printers (LaserJet Only) “Others _______________________________

(Please note: Although we do refurbish old computers, CFS is not a recycling centre and we cannot accept ineligible equipments)

Comments: ________________________________________________________________________

_________________________________________________________________________________

Please take a moment to answer a few short questions; your input is important to us!

Which of the following reasons made the most impact on your decision to donate?

“ Surplus “ Recycling/Environment “ Hands on training opportunities for IT Grads

“Educating Students “ Tax Receipts “ Other: ______________________________

How often do you have surplus computers?

“ Every __________________________________________________________________________

Contact Information: ________________________________________________________________

_________________________________________________________________________________

Please fax completed form to: 867-766-3983

CFS-NWT Workshop Location

5003- 48th Street Basement Suite

Yellowknife, NT Canada X1A 1N4