Computer Equipment Request Form

Note: this form is not a final order. All requests must be approved by the centre responsible in your province or territory. Once your request has been received, a technician will contact you to confirm the details of your request.

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All fields marked with a red asterisk * must be completed. If, after clicking on "Submit", you do not see a summary of your request, please make sure that all fields have been filled out correctly.

Attention: some fields can only be filled with numbers.

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Information

*Name of school, organization, library or Aboriginal community

*Address

*City

*Province/Territory

*Postal Code

*Telephone Number

Fax

Registration number issued by the Canada Revenue Agency (NPO only)

*Contact Name

*Contact Title

*Contact Email

*Contact Phone Number

Type of equipment

*Number of desktop computers requested

*Number of laptop computers requested

*Monitors

*Printers

*Digital scanners

*Servers

Equipment specifications

*Speed (MHz)

*Memory (RAM)

*Hard drive (Gig)

*Windows 7 operating system required:
Yes No

* Applicants may be asked to pay for the cost of upgrading donated computers to meet their specific needs.

*Description: Project description and requirements; provide a brief description of how you wish to use the equipment and any other relevant information.