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CLiCK provides free computer assistance to those in the community who are in need and who do not currently own a computer and who are having trouble affording computer facilities.

This application form is used purely as a guide so CLiCK can determine eligibility and/or any other requirements that you may need.

No information disclosed in this application form will be passed on to any other organisation(s) as required by Australian Federal and State Privacy Laws.

 

You can also download application forms here 

 

 

 

Personal Details
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Application Details
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Pickup Details
  2. *** Monitors will not be included. Package and handling fee will be added to cost of postage
Agreement
  1. I, the undersigned, hereby certify that in applying for computer equipment from CLiCK, I understand and agree to the following:
  2. • All answers have been answered truthfully to the best of my ability
  3. • That my household does not currently have access to computer facilities, or that current household computer facilities do not adequately cover the household’s needs which I have outlined in my application
  4. • Submission of this application form does not automatically entitle me or the organization which I represent to assistance from CLiCK
  5. • That I do not intend to sell any computer facilities that may be given to me by CLiCK at the time of submitting the application
  6. • That, if approved, I will pick up or organize pickup of all equipment assigned to me within 30 days, if I do not organize pick up within 30 days the equipment will be assigned to another waiting applicant.
  7. • That I will be requested to provide relevant documentation regarding my identification and circumstances before my application will be fully processed
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Submission Verification
  1. Captcha
 

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