1. Computer Request
3. Information & Donations
Disabled Consumer
Potential DONOR needs contacting and information
Nonprofit Organization
Potential CLIENT needs contacting and information
Purchase
PotentiaL VOLUNTEER needs contacting
2. Support Request:
4. Feedback:
Hardware/Software problem
Positive
Internet connection problem
Neutral
Other
Negative
Comments:
Address:
City:
State/Prov:
Country:
Zip/Post. code:
Phone:
E-mail: