C4K Donation Form — Unitarian Universalist Village Church

C4K+ Computer Donation Form

If you want the computer(s) to be picked up, expect a phone call to arrange a day and time. It you prefer to drop off the computer(s) to the C4K+ work location, bring it to the UU Village Church on Tuesday, Wednesday or Thursday between 10 am and 4 pm (403 Barcelona Road, corner of Barcelona and Callela). Come around to the back of the Community Building to a handicap ramp entrance. A sign inside points to the C4K+ work rooms.

(An asterisk “*” on an entry box below indicates that the information is required.)

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Make and Model of PCs or Macs

Operating System (i.e. Win XP, Vista, 7, 8.1)

Select “Yes” if you want a tax receipt

Yes - If checked, please include email address above.

Please tell us how you learned about C4K