Donation Form

* Indicates required information.

*	Please indicate your support choices: We will donate computer equipment as it becomes available We have computer equipment to be picked up now We will prepare and deliver our donated equipment We will provide infrastructure support for operations We will donate advertising space
Additional information on the equipment donated:
*	When will your equipment be available to the program?
*	What type of equipment and how many are being donated?:
	Other level of donations. Please indicate nature Transportation Warehousing Volunteers Other
	(specify)
Additional information about the donator
*	Company Name/Private Donor Name
*	Mailing Address
*	Phone #
*	Fax#
*	Contact Person
*	Email Address
*	Title