<p> APPLICATION FORM FOR REFURBISHED IT EQUIPMENT</p><p>Dear Applicant,</p><p>ReCOM provides refurbished PCs to voluntary organisations that serve the disabled and disadvantaged in the UK.</p><p>We provide Desktop computers with a minimum specification of a Pentium D/Dual Core Processor (with 1GB RAM, CD-ROM & internet connection), 17” TFT monitor, keyboard and mouse for £100.00, or a higher specification Pentium D/Dual Core Processor with 2 GB RAM, plus 17” TFT monitor for £110.00. </p><p>We also provide Laptop computers with a minimum specification of 2GB RAM, 80 GB Hard Drive, CD-ROM & Wifi connection for £110.00, or a higher specification with 4GB RAM, 160 GB Hard Drive, CD-ROM & Wifi connection for £130.00. </p><p>Delivery is an additional £15.00 per computer. </p><p>All our computers come with Windows 7 and Microsoft Office 2010 which are provided through our membership of Microsoft’s Authorised Refurbisher Scheme</p><p>A 3 month non-accidental back to base warranty including parts & labour is provided. </p><p>The availability of equipment depends on the availability of donations and our waiting list. </p><p>If you require a higher specification which is not listed, please contact us for a quote before sending an application form. The phone number is 0121 663 0335. Email address is [email protected]</p><p>Please ensure that a Trustee or Manager signs the application.</p><p>Thank you.</p><p>ReCOM Limited. Phone: 0121 663 0335 Registered in England & Wales with Company No: 4188742 Registered Office: 23 Knowle Wood Rd, Dorridge, West Midlands, B93 8JJ Email: [email protected] ReCOM Limited. Registered in England and Wales with Company No:418872. Charity Registration Number:1091315www.recom.org.uk Registered Charity: 1091315. Registered Office: 23 Knowle Wood Rd, Dorridge, West Midlands, B93 8JJ Phone 0121 663 0335 Email: [email protected] ReCOM Limited. Phone: 0121 663 0335 Registered in England & Wales with Company No: 4188742 Registered Office: 23 Knowle Wood Rd, Dorridge, West Midlands, B93 8JJ Email: [email protected] ReCOM Limited. Registered in England and Wales with Company No:418872. Charity Registration Number:1091315www.recom.org.uk Registered Charity: 1091315. Registered Office: 23 Knowle Wood Rd, Dorridge, West Midlands, B93 8JJ Phone 0121 663 0335 Email: [email protected] Page 1 of 2 Voluntary Organisation Contact Details</p><p>Details of Organisation Details of Contact Person Name of Organisation Name of Contact</p><p>Position in Organisation Address: Address – if different from organisation:</p><p>Postcode: Postcode: Telephone: Telephone:</p><p> web-site: e-mail:</p><p>Registered charity no: Alternative telephone number or mobile:</p><p>Organisation’s Scope & Purpose</p><p>ReCOM provides refurbished PCs to voluntary organisations that serve the disabled and disadvantaged in the UK. Please tell us briefly about your organisation </p><p>Please tell us briefly what the computers will be used for so that we can understand any special requirements you may have</p><p>Profile of your clients. Please tick all the relevant boxes below.</p><p>← Children ← Disabled & their carers ← Victims of crime ← Young people ← Visual impairment ← Offenders/Ex offenders ← Elderly people ← Hearing impairment ← Mixed ethnic groups ← Families ← Mental health needs ← Mainly Black & Minority Ethnic ← Adults ← Physical health needs groups ← Lone parents ← Homeless people ← Mainly White ← Low income households ← Refugees & immigrants ← Other (please specify)….………. ← Unemployed</p><p>For Internal Use Date application received: ReCOM Application number allocated:</p><p>Invoice No: Invoice Date: Invoice Amount: ReCOM Limited. Phone: 0121 663 0335 Registered in England & Wales with Company No: 4188742 Registered Office: 23 Knowle Wood Rd, Dorridge, West Midlands, B93 8JJ Email: [email protected] ReCOM Limited. Registered in England and Wales with Company No:418872. Charity Registration Number:1091315www.recom.org.uk Registered Charity: 1091315. Registered Office: 23 Knowle Wood Rd, Dorridge, West Midlands, B93 8JJ Phone 0121 663 0335 Email: [email protected] Page 2 of 2 Details of PC Required</p><p>ReCOM provides refurbished Desktops and Laptops with a minimum spec of a Pentium D/Dual Core Processor (2.5 GHz processor with 1GB RAM, CD-ROM, USB and Ethernet connections), 17” TFT monitor, keyboard and mouse. 19” TFT monitors are sometimes available at an additional cost. The Laptops have a minimum spec of 2GB RAM, 80 GB Hard drive, CD-ROM & Wifi connection. We install a Windows 7 operating software and Microsoft Office 2010. This will provide you with Word, Excel and PowerPoint.</p><p>To cover the costs incurred in refurbishing the Desktops we charge £100 for the minimum specification Pentium D/Dual Core Processor with 1GB RAM plus 17” TFT monitor. A higher spec Pentium D/Dual Core Processor is available with 2GB RAM for £110. Laptops with a minimum specification are available for £110; higher specification is available for £130. These prices do not include delivery. </p><p>Equipment carries a 3 month non-accidental back to base warranty including parts & labour. </p><p>Your Desktop / Laptop will be available for collection from our workshop in West Bromwich or at our offices in Olton, Solihull. We can arrange delivery to anywhere in mainland UK for an additional £15 per system. Delivery to Northern Ireland can be provided at an additional cost.</p><p>Pentium D/Dual Core Processor, 1GB RAM @ £100 each Yes/No Number Required: ______with 17” flat screen monitor. Pentium D/Dual Core Processor, 2GB RAM Yes/No Number Required: ______with 17” flat screen monitor. @ £110 each Laptop computer, 2GB RAM , 80 GB Hard @ £110 each Yes/No Number Required: ______Drive Laptop computer, 4GB RAM ,160 GB Hard @ £130 each Yes/No Number Required: ______Drive</p><p>Do you require a 19” flat screen monitor if available (an additional £15 each)? Yes / No</p><p>Delivery options - Will you collect from West Bromwich? Yes / No - Will you collect from Olton, Solihull? Yes / No - Do you require delivery (an additional £15 per system)? Yes / No ReCOM will try but cannot guarantee to fulfil any special requirements from our stock of donated equipment (eg additional RAM memory). Please indicate what requirements you have: </p><p>...... </p><p>We sometimes have a waiting list. How long are you prepared to wait? ← Up to one month ← Up to 3 months ← Other……………………………..</p><p>Signature & Summary</p><p>I wish to apply to acquire the refurbished PCs described above. </p><p>Signed by ……………………………………………………….. Date …………………</p><p>Print Name ………………………………………………………</p><p>Position in Organisation ………………………………………..</p><p>ReCOM Limited. Phone: 0121 663 0335 Registered in England & Wales with Company No: 4188742 Registered Office: 23 Knowle Wood Rd, Dorridge, West Midlands, B93 8JJ Email: [email protected] ReCOM Limited. Registered in England and Wales with Company No:418872. Charity Registration Number:1091315www.recom.org.uk Registered Charity: 1091315. Registered Office: 23 Knowle Wood Rd, Dorridge, West Midlands, B93 8JJ Phone 0121 663 0335 Email: [email protected]</p>