Request a Refurbished Computer
for a Non-Profit Organization

Contact Information Organization Name: * This is a required field Contact Name: * This is a required field Email Address: * This is a required field Web Address: Enter the EIN number for your Non-Profit Organization Who referred you to our site Street Address: City: State: AL CA DE DC FL HI ID IL IN KY ME MD MA MI MO NV NH NJ NY NC OH OK OR PA RI SC TX VT VA WA WV WI Zip+4 Code: Country: United States Telephone: Fax Number: Organization Background Do you represent: 501(c)(3) Non-profit Organization Other Non-profit Organization What population does your organization serve? Elderly Children, Youth, and       their Families Vulnerable Adults Multiple Populations Hardware Requested What type of computer are you seeking from us?: How many computers do you need: Note, if you are requesting 10 or more computers we strongly urge you to ask someone from your organization to work with us for a while to learn how we refurbish computers, so that if something goes wrong with any of the machines we provide you, he/she would be in a position to try to fix the problem. Anyone is welcome to work with us to learn how we do it, but for organizations receiving 10 or more computers we strongly urge them to designate someone for this task. Please outline your plans for the use of the computers you are requesting If your donation request is granted, will you have any surplus equipment that you will be willing to donate back to HelpingTulsa so it may be refurbished and passed on to someone else who can use it?If so, please list here: Does your organization have a web site? Yes No How long have you had your web site: If you dont have one, would you like a web site? Yes No If you could find someone to host it, do you have anyone that can build a web site Yes No How often does your organization post new information on your Web site? Daily Several times a week Weekly Monthly Less Often Who is primarily responsible for Web site content?: