Equipment Donor Application

Your Name:

Your Email:

Your Phone:

Equipment Details:

What was the original cost of the equipment?

What company was it purchased from?

In what year was it purchased?

What is the condition of the equipment you are wanting to donate?

By checking this box, you are signifying that you are gifting this piece of equipment to the Kenadi Jean Weis Foundation to help support their mission and vision.  You are giving up the rights to owning this piece of equipment and allowing the Kenadi Jean Weis Foundation to use it at their discretion.