Computer Application

This form will help us to determine whether your organization is a potential recipient and will help us to assess your hardware and software needs.

In order to receive equipment from reBOOT Canada, your organization must be a registered charity.

The application will be sent to reBOOT Canada via e-mail.


Organization's Name
Contact's Name
Telephone Number
Fax Number
E-Mail Address
Mailing Address
Charity's Registration Number
How did you hear about reBOOT Canada?
Please describe your organization's activities.
How many employees does your organization have?
What is your budget for computer equipment?
What system(s) do you currently have?
What will you use the computer(s) for?
If you have a preference for a particular computer model, please enter it here.