Labdoo Laptop Request Form

Requester Information:
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Your Name: Frank Held
Your Email Address:info@cvjm-muelheim.de
Your Organization :CVJM Christlicher Verein Junger Menschen Mülheim an der Ruhr e.V. (YMCA)
Organization Website:www.cvjm-muelheim.de
You Labdoo account user name: 

Project Site:
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1.  Project Summary: (Please provide a brief statement about the purpose that the laptops will serve in your project site.)
Der CVJM Mülheim an der Ruhr bietet neben vielen anderen Aktivitäten auch eine Mittagsbetreuung für junge Menschen an, inklusiv Hausaufgabenbebtreuung und IT Unterricht. Hierzu soll ein neuer Computerraum eingerichtet werden.
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YMCA Mülheim an der Ruhr offers beside many other activities also for young people support for homework and computer training. To improve the thraining an new IT room will be set up.
2.  Project Location:Teinerstraße 3-5, 45468 Mülheim an der Ruhr
3.  On-site Point of Contact Name:Frank Held
4.  Contact Information (please provide at least one way to contact):
    4.1. Phone:+49 (0)208 38 16 88
    4.2. Email:info@cvjm-muelheim.de
    4.3. Physical address:Teinerstraße 3-5, 45468 Mülheim an der Ruhr
    4.4. GPS coordinates (if you know them or if you can find them out):
    51.42589, 6.88310
5.  Number of Laptops Needed: 7
6.  Number of students:___
7.  Number of teachers:___
8.  Electricity in the room: 220V, A, B
9.  Does the room have access to the Internet? [yes / no]
    9.1. Is the access via wireless or cable?
10. Conditions about the room where the laptops will be installed:
    10.1. Is the room secure? [yes / no + brief explanation]
    10.2. Can the room be locked in a way that the supervisors (e.g. teachers) can control access? [yes / no + brief explanation]
    10.3. Is the room weather-proof? (e.g. does the room protect the laptops from rain, sand, etc?) [yes / no + brief explanation]


***The solicitation of a Labdoo laptop request implies that, upon receiving the laptops, the recipient agrees with the "Labdoo Laptop Recipient Agreement".

Labdoo Laptop Recipient Agreement:
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Dear Laptop receiver:

We are very pleased to have the opportunity to contribute to your project by providing technology to help bridge the digital divide. 
With every right comes responsibilities. Technology, when adequately used, can provide very powerful means to aid those that are 
most in need. But if used improperly, it can also damage our environment. By receiving the above items, you are automatically a
ccepting to abide by the following Labdoo global responsibilities:

(1) The items received will be used only for the purpose described by your organization at the time you solicited this donation. 
If you intend to use it for a different purpose, you will contact first the Labdoo team at contact@labdoo.org.
(2) In the case that an incidence occurs to any of the received items, you will contact the Labdoo team at contact@labdoo.org, 
including in your email the tagging number of the item(s) related to the incidence and a brief explanation. The following 
incidences must always be reported:
	(2.1) At the end of life of any of the received items, so that the item can be properly recycled. 
	(2.2) When an item breaks, malfunctions or any change in its status.
(3) Every six months, please send an email to contact@labdoo.org with the list of laptops that you have and their status (working or not working).

We thank you for your commitment to make our world a better place and we wish you best of luck in your humanitarian mission.

The Labdoo Team.