* Request Form:
Organization Name:
Upload your logo:
Description:
Your Name:
Type:
Non-Profit Number
Address Line 1:
Address Line 2:
City:
Province:
Postal Code:
Country: Canada
Email Address:
Phone Number:
Purpose Of Request:
Deadline:
Is This Your First Request?
Website
* Requested Equipment:
Low-End Desktop Computers
High-End Desktop Computers
Low-End Laptops
High-End Laptop
Laser / Toner Printers
LCD Monitors
Projectors
* Comments / Captcha:
Comments / Special Requests
Captcha