Device Donation Scheme Application Form


2econd Chance is a not-for-profit computer recycling company committed to bridging the digital divide by providing access to refurbished technology.
We are reliant on donations of unwanted devices so our stock continually changes.
All efforts will be made to match applications with suitable devices but a member of the team will be in touch to discuss options if needed.

Eligibility Criteria

  1. Referrals must be made through an organisation.
  2. Cap of two referrals per organisation a month.
  3. On Collection, individuals are requested to provide us with a quote about how they will use their device.
  4. Referral organisations are required to support individuals completing evaluation forms so we can track impact.
  5. All devices must be collected from our office within 10 days of acknowledgment.

Referral Organisation

1. By applying for a device you agree to sharing resident/client personal data with 2econd Chance.
This is important for our evaluation purposes and to demonstrate to funders the impact of the scheme


2. Individuals who receive devices from 2econd Chance are required to complete both a 6 and 12 month evaluation form. Do you agree to support your client with both forms?


3. Organisation name
4. Contact name
5. Contact email address
6. Contact phone number
7. Organisation structure





8. Registered company, charity, or VAT number
9. Who are your service users?





10. What area of London does your organisation work in?






11. How did you hear about 2econd Chance?





London Borough of Barnet Organisations only

Leave blank if working in other areas
12. Organisations working in the London Borough of Barnet must already be a member of the Barnet Get Online Network (www.barnetgetonline.org). If not please email getonline@barnet.gov.uk
Is your organisation already a member?


13. Which of the following free drop-in workshops will the recipent attend?












Recipient

14. Name of recipient
Only used for demographic analysis/reporting
15. Age range of end user





16. End service user's postcode
17. Reason the end service user needs a laptop




18. Is this person in financial hardship?


Donated Devices
Organisations can only apply for two fully subsided devices a month.

19. Which of the following devices are you applying for?