iPad/Tablet Donation Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you so much for donating your iPad/tablet to our cause!

We accept all iPads, except for the very first generation as it does not come with a camera. By providing us details about your iPad/tablet we can get back to you and let you know whether your device is suitable for donation.

Email address: *

First & Last Name *

Where are you located? (City) *

What is the MAKE of the device you'd like to donate? *

Apple iPad

Other:

What is the MODEL NUMBER of the device(s) you'd like to donate? *

For Apple iPads, the model number starts with 'A' followed by four numbers and can be found engraved near the bottom at the back of the device. List all numbers for all devices you'd like to donate (if you are donating multiple)

How many devices are you donating? *

Other:

How many chargers are you donating? *

Other:

How can we get your donation from you? *

Someone can pick it up from me (this is possible depending on location)

I can mail it (after you submit this form, we will email you with mailing instructions)

We thank you again as each iPad/Tablet donated will assist us in our goal of connecting as many patients to their loves ones as possible.

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms