Project
PCReNew
 ROCKLAND PCUSERS GROUP
Request a Computer from PCReNew

A service of the Rockland PC Users Group
PCRENEW
 PO Box 802
New City NY 10956
(845) 638-1917
Enter your information below. An asterisk (*) indicates required information.
*Name:
*Address:
*City:
 *State: *Zip:
Email:
*Phone:
 Day: Eve: Cell:
*SS#
Age:
 Occupation:
Annual Family Income $
*Do you currently own any computer? yes no
If yes, How many?
Do you know have Internet access? Cable DSL Dial Up
Do you know how to operate a computer? yes no
 
What will you use this computer for?
Word Processing Record Keeping
Internet Games School
Other (describe)
   
Please tell us why you want us to donate a computer to you.