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Intake form
Help us serve you better
Name
*
Email address
*
What type of electronics are you donating or selling?
Please select at least one option.
Computers
Laptops
Cell Phones
Tablets
Monitors
Printers
How many items are you looking to donate or sell?
What is the condition of the electronics?
Select
New
Like New
Used
Non-Functional
Do you need assistance with transportation for your donation?
Select
Yes
No
Would you like to receive information about our repair and donation programs?
Select
Yes
No
Please specify any specific items you would like to donate or sell.
Additional questions or comments
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