Requester Information: (*) is a mandatory field
    --------------------------------
    Requestorâ%%s Name(Sr. Clare Nyoni*):
    Requestorâ%%s Email Address(nyoniamanda@yahoo.com*):
    Your Organization(Ndanda school of Nursing*):
    Organization Website http://www.ndandahospital.org / Facebook:
    Your Labdoo account user name (https://www.labdoo.org/user/register):
    --------------------------------
    Project Site:
    --------------------------------
    1. Project title or name of your school, project, or NGO - A short title or 
    description for your project(Ndanda School of Nursing*):
    2. Project Description - Please explain about your project and how you will use 
    the laptops (The project is aiming  to help nurse students learn how to use them and be able to search academic materials online.*):
    3. Number of students(179*):
    4. Number of teachers(10*):
    5. Claimed IT equipments (11*)
    5.1 Number of Laptops needed(10*):
    5.2 Number of eBook Reader needed: 3
    5.3 Others needed (Tablet-PCs etc):
    5.4 Additional comments: I requested eBook Reader because we have none in our library and I did not know if you have access for that, so above I requested 3 if possible.
    6. On Site Contact Information / project manager. Please provide at least one 
    way to contact (Email*):
    6.1 Full Name(Sr. Clare Nyoni*):
    6.2 Phone(+255-682412144*):
    6.3 Email(nyoniamanda@yahoo.com*):
    6.4 Physical address of Organization (street, city, zip code, country...)(Ndanda school of nursing, P.O BOX 16, Mtwara- Tanzania*):
    6.5 GPS coordinates (click the link to find the coordinates: https://www.gps-
    coordinates.net or https://support.google.com/maps/answer/18539)(*):
    7. Language - English
    7.1 Local / Preferred language(s)(English and swahili*):
    7.2 Additional information about language(s): The National language is Swahili but in school we insist students to speak English for learning purpose.
    8. Project Location - street, city, state/province, country, zip code(*):
    9. Access to Internet(*)?
    9.1 Access to internet (yes)
    9.2 Wired/cable (yes)
    9.3 Wireless (yes)
    10. Conditions about the room where the laptops will be installed:
    10.1 Is the room secure? [yes, with aluminium windows and air condition]
    10.2 Can the room be locked in a way that the supervisors (e.g. teachers) can 
    control access? [yes, The room is locked and opened when the students has computer classes with a teacher and always the is one staff who is taking care ]
    10.3. Is the room weather-proof? (e.g. does the room protect the laptops from 
    rain, sand, etc?) [yes, the room is well protected no possibility of rain coming in. + brief explanation]
    11. How did you hear about Labdoo?
    --Search Engine (e.g. Google)
    --At local Conference,
    --At online Conference,
    --From other organizations/companies,
    --Facebook
    --Instagram
    --Other (I heard when I visited the nearby nursing school Dr. St. Thecla and saw the laptops donated by labdoo, Sr. Raphaela Haendler helped me to get your email address and that of Dr. Winfried zacher whom you helped him. please describe)
    12. Picture(s) of the school, students, teacher, etc with this Request Form. 
    Please send as file(s) (*):
    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:
    ------Yes I agree. ----------------------------------------------
    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.