Affordable Tech program Application
This application is for organizations requesting affordable technology for both internal or on behalf of community members they serve.
Sign in to Google to save your progress. Learn more
Name of Organization *
City *
Primary Contact Name *
State  *
Primary Contact Email *
What is the mission of your organization? (Please describe how your organization serves the community) *
Does your organization comply with Free Geek’s anti-discrimination policy? "Free Geek is a diverse, accepting, and inclusive community that specifically does not tolerate discrimination. No person shall be denied the services or facilities of Free Geek or be excluded from participation or service because of race, age, color, sex, sexual orientation, gender identification, creed, religion, handicap, or national origin. Discrimination of any kind in respect thereof is expressly prohibited. In accordance with Free Geek By-Laws, organizations are not eligible to participate in the Affordable Tech program if they have a policy or mission which allows discrimination in hiring, compensation, promotion, termination, retirement, training, programs, and/or services based on race, color, sex, national origin, religion, age, disability, gender identity or expression, marital status, pregnancy, sexual orientation, political affiliation, union membership, veteran status, or any other characteristic protected by federal, state, or local law, regulation, or ordinance. Educational institutions or nonprofit organizations which offer culturally-specific, gender-specific, or community-specific programs or services may not, in and of themselves, be considered discriminatory." *
Does your organization have a website, social media pages, or online articles about your activities? Please provide the address of your organization's web site and any other pages with information on your organization and its activities. *
What are your technology needs (Laptops, Desktops, Monitors)? *
How many laptops/desktops/monitors do you need? *
Which cause does your organization primarily serve? *
What is your estimated budget? *
Are you or another representative from your organization going to be able to come to our Portland, Oregon location to pick up the ordered items? *
What are your goals for how this technology will be used? *
Operating system details   *
Clear form
Never submit passwords through Google Forms.
This form was created inside of Free Geek.