Please enable JavaScript in your browser to complete this form.Name *FirstLastCompany (optional)Company Contact Name (if different from above)FirstLastStreet Address *Street Address 2City *State *Zip Code *Email *Contact Phone *This donation is a (check all that apply): *Computer(s) - LaptopComputer(s) - DesktopPhone(s)Tablet(s)Estimated Fair Market Value: *Please tell us the fair market value of the donated item(s). This information will be used to acknowledge your in-kind gift and for reporting to the Internal Revenue Service (IRS)Description (Please include Brand, Model # and Condition):Shipping Date *How soon are you able to ship the items you are donating? Month/Day/Year. Estimated date is fine.I plan to cover shipping cost *YesNoSelect "yes" or "no"My Item(s) is (Check all that apply):NewUsedHas a cracked ScreenIn Excellent Working ConditionIn Fair Working ConditionIn Poor Working ConditionDamaged and Needs RepairMy donated item(s) includes the following AccessoriesCase/CoverCharger(s)KeyboardMonitorMouseOtherComments or QuestionsBy submitting this form: *I hereby certify that I am the owner of the property described above and I have the legal right to transfer ownership to the LITE Foundation.NameSubmit
