DigiKnow Devices Referal

This is not a guarantee of a device. Once you have completed this form, a member of the Starting Point team will contact the nominee to discuss their requirements. Many thanks

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* 1. Your Name

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* 2. Your Organisation

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* 3. Your Email

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* 4. Your Phone Number

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* 5. Details of Person Requiring a Loan Device

Name

Company

Address

Address 2

City/Town

Postal Code

Email Address

Phone Number

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* 6. What Loan Equipment Would This Person Benefit From?

Laptop (School aged families only)

Tablet without (data) SIM card

Tablet with SIM (data) card

Data SIM card

Don't Know

Other (please specify)

DigiKnow Devices Referal

Question Title

* 1. Your Name

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* 2. Your Organisation

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* 3. Your Email

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* 4. Your Phone Number

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* 5. Details of Person Requiring a Loan Device

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* 6. What Loan Equipment Would This Person Benefit From?

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* 7. Why do you think this person would benefit from a device?

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* 8. Is there anything else we should know?