======================English Version======================(Updated 25-02-2019) Requester Information: (*) is a mandatory field -------------------------------- Requestor’s Name(*): Sarah Thurmann Requestor’s Email Address(*): sarah-thurmann@hotmail.de Your Organization(*): IMPCT gGmbH Organization Website / Facebook: https://impct.help/ Your Labdoo account user name (https://www.labdoo.org/user/register): -------------------------------- Project Site: Sorong City, West Papua, Indonesia -------------------------------- 1. Project title or name of your school, project, or NGO - A short title or description for your project(*): Ecoducation Atap Langit – Village Youth Development Program 2. Project Description - Please explain about your project and how you will use the laptops (*): 3. Number of students(*): 24 4. Number of teachers(*): 4 5. Claimed IT equipments (*): 0 5.1 Number of Laptops needed(*): 12 5.2 Number of eBook Reader needed: 0 5.3 Others needed (Tablet-PCs etc): 5.4 Additional comments: 6. On Site Contact Information / project manager. Please provide at least one way to contact (*): 6.1 Full Name(*): Daniel Hamdani 6.2 Phone(*): +62 82397006106 6.3 Email(*): hdaniel707@gmail.com 6.4 Physical address of Organization (street, city, zip code, country...)(*): Jl. Sam Ratulangi no. 08, Kampung Baru, Sorong City, West Papua 98413 6.5 GPS coordinates (click the link to find the coordinates: https://www.gps-coordinates.net or https://support.google.com/maps/answer/18539)(*): 0°52'24.3"S 131°14'55.5"E 7. Language 7.1 Local / Preferred language(s)(*): Bahasa Indonesia / English 7.2 Additional information about language(s): Some of the students are able to speak English fluently while the rest understand English but are unable to speak. All of the students are able to speak Bahasa Indonesia Fluently. 8. Project Location - street, city, state/province, country, zip code(*): Jl. Sam Ratulangi no. 08, Kampung Baru, Sorong City, West Papua 98413 9. Access to Internet(*)? 9.1 Access to internet (yes/no): YES 9.2 Wired/cable (yes/no): NO 9.3 Wireless (yes/no): YES 10. Conditions about the room where the laptops will be installed: 10.1 Is the room secure? [yes / no + brief explanation]: Yes, the room is secure and the premises is enclosed and almost never left unoccupied 10.2 Can the room be locked in a way that the supervisors (e.g. teachers) can control access? [yes / no + brief explanation]: Yes, the room can be locked and the supervisors and housekeepers can control access. 10.3. Is the room weather-proof? (e.g. does the room protect the laptops from rain, sand, etc?) [yes / no + brief explanation]: Yes, the room is weather-proof. 11. How did you hear about Labdoo?: --Search Engine (e.g. Google) X --At local Conference, --At online Conference, --From other organizations/companies, --Facebook --Instagram --Other (please describe) 12. Picture(s) of the school, students, teacher, etc with this Request Form. Please send as file(s) (*): attached to Email The picture will be uploaded to your project site ***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: ---------------------------------------------------- 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 accepting 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. (1.1) If you intend to use it for a different purpose, you will contact first the Labdoo team at contact@labdoo.org. (1.2) Only schools and projects may claim for Labdoo computer donations and not by individuals. (1.3) Donated items may only be removed from school ground with admittance of Labdoo (example, teachers cannot take laptops outside school). If Labdoo reviser visit your project and discovered donated items are missing, your school / project will be excluded from Labdoo support and CANNOT receive any further donation. (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). (4) Labdoo laptops are offered for free to you for education purposes. In return, you agree to not use the laptops for commercial reasons and you agree not to charge any fee for the usage of the laptops. (4.1) The donated items cannot be resold to make money or exchange with other valuable items. (4.2) If discovered donated items are missing, your school / project will be excluded from Labdoo support and CANNOT receive any further donation. (5) By returning this form filled in, the solicitor confirms owning all rights on sent materials (current or in the future) submitted to Labdoo.org and allowing such content to be publicly available from Labdoo.org. In addition, the solicitor confirms having approval for taking pictures of the children and/or any person benefiting from Labdoo laptops, tablets or any Labdoo donations, from their parents and/or legal guardians. Labdoo.org explicitly points to the fact that sent materials and pictures/photos may be used online and/or offline, and hence that they can be accessed by third parties, and that such pictures are used to help preserve the transparency and accountability of the projects. 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.