Request a Computer for a Non-Profit Group or Charity

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Personal information on this form is collected under section 31(c) of the Freedom of Information and Protection of Privacy Act for program administration purposes. Questions regarding the collection or use of this information can be referred to the program coordinator at 902-620-3226 or Access and Privacy Services at 902-569-0568.

Identification
For example C1B 0X1 or 12345
For example 902-555-5555
For example 902-555-5555
For example 902-555-5555