Application form
/Name of Applicant
Name of Organisation
applies for the donation of ex-government computers for the purposes outlined within this application with the understanding that certain terms and conditions will apply.
Description of community activities undertaken by organisation/group
Include an outline of community benefits, community involvement or membership. Supporting material may also be attached.
Intended purpose or use of computing equipment
Please describe actual task or activity, nature of program, etc. Supporting material may also be attached
Description of equipment requested / Number requested
Please ensure sufficient information is provided above to justify your application
Desktop computers:
Laptop computers: Due to the limited number of laptops available, applicants will need to define the circumstances that necessitate these on this application form.
Organisation’s contact details:
Address 1
Address 2
Postcode (mandatory)
Telephone Number
Applicant’s contact details:
Name
Position Held
Address 1
Address 2
Phone numbers:Please include daytime contact numbers
Signature
Date
Post to
Attention: Computers for the Community
Department of Business
GPO Box 3200
Darwin NT 0801
Fax
Attention: Computers for the Community (08) 8999 7022
Eligible requests may be placed on a waiting list and equipment will be distributed throughout the period as it becomes available.
Only one application from each organisation will be considered during the application period, unless separate entities (e.g. branches, regional groups) exist within the organisational structure.
Department of Business
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