Request for Computers
by an Individual Applicant

Please take your time to complete the following request form. It is important you understand the conditions under which this application will be accepted or declined.

The criteria are listed here. NOTE: Only 1 computer per family unless there are exceptional circumstances in which case you should provide justification in the supporting information. For laptops must justify why a desktop will be unsuitable.

After you submit this form, you will receive an email confirming your order. The email can be printed, and contains your Request Number, which is required for any enquiries.

*Required information (Please make sure any marked field is filled in)

Today's date :

 

 

 

 

 

 

* Supporting statement. Include the following as required.
1. Purpose for which computer will be required.
2. List of documents supporting disadvantage that you can bring with you when collecting order.
3. Justification if applying for Laptop.
4. Supporting statement for more than one computer per family.

 

 

State
 
     

 

Postal State
 
   
     
     

ORDER DETAILS

 Number
Req'd
Price
Desktop PC.... Cost $50
Typically P4 processor loaded with Windows XP PRO and Open Office freeware software which is similar to Microsoft Office.
Microsoft Office 2003 added to Desktop ....Cost Additional $20 (Not available separately)
This is a special stock run out price while stocks last.
Laptop PC.... Cost $100
Rarely available. Please note we cannot guarantee the life of the battery, and battery packs can be $100 or more to replace. Justification is required for why a Laptop is required and a Desktop will not be satisfactory.
Microsoft Office 2003 added to Laptop ....Cost Additional $20 (Not available separately)
This is a special stock run out price while stocks last.

Box for computer system.... Cost $5
Only required if applicant is arranging for a Courier to collect


GRAND TOTAL

 
$
(Click equal button to obtain total)

MS Office is a short version of the Microsoft Office suite.It includes Excel, Word, PowerPoint, Outlook and can be loaded on Deskttops and Laptops.
Eligibility Declaration. *    
Do you meet the eligibility criteria and can you provide documentary evidence to support this when collecting the computer and do you understand that the licence forbids re-sale of the computer?
Yes, I agree to these conditions.