Request for Computers

Please take your time to complete the following request form. It is important you understand the conditions under which this application will be accepted or declined.

Please check the criteria required before an application can be considered.

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Make sure that EVERY field is satisfied. Any field not completed will deem this application void.

Today's date :

Dear Validations Manager,
On behalf of
(insert name of organization or recipient here)

which is :
A Charity Non-Profit OrganizationEducation FacilityIndividual Applicant

Computer Type Requested & Cost:	Qty Requested
Low End PC .... Cost $30 typically a P3 processor,loaded with Windows 2000 PRO and Open Office freeware software which is similar to Microsoft Office.
High End PC . . Cost $50 Typically P4 processor loaded with Windows XP PRO and Open Office freeware software which is similar to Microsoft Office.
Laptop PC ... Cost $100 rarely available. Please note we cannot guarantee the life of the battery, and battery packs can be $100 or more. Justification is required for why a Laptop is required and a Desktop will not be satisfactory.
Microsoft Office XP Standard ... Cost Additional $50 (short version of Office suite. Includes Excel, Word, PowerPoint, Outlook) which can be loaded on High-End PC's and Laptops.

State fully the purpose for which these computers will be required

The above mentioned organisation and myself are aware that a payment per system (See above for Pricing Details) is payable to The Rotary Club of Nundah, upon collection of these computers:
Yes No

Should the computers supplied to this organization be given or loaned to a third party this organization agrees to the following:

The circumstances of the end user will be satisfactorily investigated to establish a genuine need exists and that the end user has a genuine and financial or social disadvantage. The Computers 4 Kids program reserves the right to request any additional information regarding end users and their eligibility to receive a refurbished computer. (All non-profit/charity applicants may be required to supply on their official letter head evidence which shows their non-profit status)
That the family circumstances of the end user will preclude the possibility of the machine being pawned or resold.
I/We also understand that we will be required to read and sign an Eligible Recipient License Agreement to satisfy the software licensing requirements for Microsoft. An End User License Agreement will be provided to the end user.

Should evidence of a breach of the above conditions, or the Microsoft Eligible Recipient License Agreement and/or End User License Agreement be bought to the attention of Computers 4 Kids then the breach will be investigated and if proven, the right to use the software installed thereon will be revoked. Matters involving deliberate misstatement, fraudulent actions or financial irregularities will be referred to the relevant statutory authorities for investigation and initiation of criminal proceedings

I/We have read and accepted the above conditions

Submission of this application to Computers 4 Kids either in hard copy form or electronically signifies agreement to the above conditions

< Yours>