Computer Intake Form - Brampton Library, Sat. June 25th

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Thank you for your donation. Every device donated makes a different towards protecting our planet while helping a fellow resident in need.

Completing this form will help expedite your intake process when you drop off the device. Please complete one form for each computer donated. Each form takes 2 - 3 minutes to complete. Registering your computer is optional. Residents are still welcome to drive up/drop off their computers without registering.

Sat. June 25th, 10am - 2pm
Mount Pleasant Village Branch Library
100 Commuter Drive, Brampton

Please contact us if you have any questions at info@letsgettogether.ca

If you'd like to get involved or volunteer, please contact us at volunteer@letsgettogether.ca

Thank you and have a wonderful day!

Ali
Executive Director, Let's Get Together

Please let us know which tech device are you donating?

laptop

desktop

tablet

chromebook

ipad

cellphone

None. Donating peripherals accessories only.

Clear selection

Peripherals Donated (Please select all that apply)

Adapter - please assess

Mouse

Monitor

Keyboard

Laptop Bag

USB Stick or External Hard Drive

Plug in Webcam/mic combo

Other:

Please share your visual assessment of the computer's condition

Poor - not working, cracked screens,

Fair - working, worn, visible scratches

Good - working, gently used

Excellent - working, like-new

Unsure

Clear selection

Hard Drive Data Erase - Please select your choice from the list below. NOTE: Each hard drive is put through a 4-pass full data wipe process with a FOG Server

Erase Hard Drive Data Only - We use a 4-pass FOG server to erase your data

Erase Hard Drive Data + Send Certificate of Data Erase

Remove Hard Drive + Return to Owner ($20 donation welcomed to purchase replacement)

Computer donated without Hard Drive

Computer Hard Drive Pre-Erased

Unsure. Would like to further discuss at the event.

Clear selection

Name *

E-mail *

Phone Number

City

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