members ∫ empowering minds   Use this form to either 1) REQUEST computers or 2) REGISTER your computer.  1) All requests for computers are grant requests.  Receipients must match Federal or committee grant criteria.  2) Warranty Registration Form - use this form to register your computer.  Computer registration is FREE.  Computer registration ensures your 100% six month product replacement warranty from the date of receipt.  Registered members may share, exchange, and receive additional resources.  Members that register their computer may also receive FREE computer training.  Members that recycle their used computer receive additional benefits. I am registering a ParityInternational.org computer: Yes No Recipient First Name: Recipient Last Name: Recipient eMail Address: Recipient Organization, Family, or Company: Recipient Address Line (1): Recipient Additional Contact Line (2): Recipient City: Recipient State (USA Only): Recipient ZIPCode or Parcel Post Code: Recipient Country Recipient Phone (###) ### - ####: Recipient Social Security Number, FEIN, or Tax Identification Number: Preferred method of contact? eMailMail (USPS, UPS, FedEx)TelephoneFacsimile (Fax)Chat (ICQ, MSN, Skype, etc.)Other Please describe your computing needs, requirements, use, environment, applications: Best time of day to contact you (##:## AM/PM): Best day or date to contact you (MM/DD/YYYY): I read and agree to the warranty registration card?