Both individuals and charitable organizations may submit a request to Recycled-PC, Inc. for a computer system. Charitable organizations will need to provide proof of their non-profit status.

To request a computer from Recycled-PC, Inc., fill out and submit the online form below. If you prefer not to apply online, you can download and print an application to mail or fax to Recycled-PC, Inc.

View and print the Grant Application (pdf) if you are unable to use the online form below.

Recycled-PC, Inc. — Online Grant Application

Recycled-PC, Inc., is a non-profit corporation serving Northern Colorado and whose stated mission is: "To refurbish and distribute computers free of charge."

As we do not have the ability to deliver equipment, you will need to contact us to make these arrangements.

* denotes required fields

Part 1: Terms and Conditions
* Agreement:		I affirm that I have read, and agree to the following terms and conditions:
		a) If I receive a grant of equipment from Recycled-PC, Inc., I will keep this equipment in my personal and/or non-profit use only. Under no circumstance will this equipment be resold, in whole or in part.
		b) If I receive a grant of equipment from Recycled-PC, Inc., I will accept this refurbished equipment in "as is" condition. This means that while Recycled-PC, Inc. will take every precaution to ensure full functionality, I alone will be responsible for any repairs, technical support, upgrades and so on that may need to occur after delivery of the equipment.
		c) I affirm that Recycled-PC, Inc. as well as its officers, employees and directors, associated subcontractors and vendors, and anyone else involved in the refurbishment and delivery of this equipment, shall be in no way held liable for any damages associated with the use of free equipment provided by Recycled-PC, Inc.
		d) If I receive a grant of equipment from Recycled-PC, Inc., I will not use this equipment for any purpose which is explicitly illegal or immoral, or which may potentially be construed by a court of law to be in violation of any civil or criminal law.
		e) If I receive a grant of equipment from Recycled-PC, Inc., I affirm that neither Recycled-PC, Inc., nor anyone associated with the company, shall be obligated to provide any post-delivery services, including but not limited to, tech support, software or hardware, spare parts, add-on equipment, general advice, or any other service associated with ownership of the equipment given to me.
Part 2: Contact Information
*Your Name:
* Your Email Address:
* Your Telephone Number:
* Which method is best to contact you:		Phone    Email
* Your Mailing Address
Street:
City:
State:
Zipcode:
Part 3: Equipment Requested
Mark all that apply:		Desktop PC (refurbished)
		Printer (refurbished)
Special requests:
		Note: You may request a lcd monitor or a laptop in the special request box above. However, Recycled-PC, Inc. cannot guarantee that any or all requested equipment will be available, or that any special requests will be able to be fulfilled. We will do our best to match our equipment with the need indicated above, but due to inventory and availability issues, we can make no guarantees in this regard. Thank you for understanding.
Part 4: Demonstration of Purpose and Need
For what purpose are you requesting this grant of equipment? (For instance: personal home use, educational use, non-profit corporation use, etc.)
NON-PROFIT CORPORATIONS: (please fill out this section)
* Are you a non-profit 501(c)3 corporation?		Yes    No
		Note: if you answered yes, please skip to Part 5 of this application.
PERSONAL USE: (please fill out this section)
* What is your annual household income?		Under $40,000    Over $40,000
If your income is over $40,000 per year, please explain why you have a demonstrated need for a grant of equipment from Recycled-PC, Inc.
* Are you a full-time student?		Yes    No
* Are you 18 years of age or older:		Yes    No
		Note: Due to legal concerns, Recycled-PC, Inc. is not able to provide equipment grants to anyone under the age of 18. We encourage applicants under the age of 18 to enlist a parent or guardian to apply for a Recycled-PC, Inc. grant on the minor’s behalf.
Part 5: Pick Up Computer Equipment
Equipment Pick Up		I understand I am responsible for picking up the computer equipment from Recycled-PC, Inc.
Part 6: Summary and Final Acceptance of Terms
* Final Terms		By checking this box, I hereby attest that all inform ation I have provided in this grant application is true and verifiable by me upon request. I also fully accept the terms and conditions indicated herein, and affirm that I understand all the notes and limitations as spelled out in this application. I also understand that submission of this application does not guarantee a grant of equipment from Recycled-PC, Inc., and that Recycled-PC, Inc. is under no obligation whatsoever to provide any requested equipment to any applicant.