OCP - SPI

Select Current Date * MM / DD / YYYY
Name of Organization
Applicant's Name * First Last
Applicant's Role
Organization Headquarters *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Tax Identification Number *
Contact Phone # *
Contact Email Address *
Please attach your organization's 501(c)(3) or non-for-profit certification. *
Is your organization a not-for-profit? *
Yes No
Provide a description of your Organization. *
Please select what describes your organization best.
Public School Library Other
Is your organization a not-for-profit that provides services to persons with disabilities, senior citizens, or low-income individuals?
Yes No
Please select form the below options, all that apply to your organization.
Persons with Disabilities Senior Citizens Low-income Individuals or Families Other
Please describe the non-profit services you provide.
Maximum of 300000 characters. Currently Used: 0 characters.
Provide an estimate of the number of people that the organization serves annually. *
GovDeals Asset Number *
Provide a description of the Surplus Equipment requested. *
Provide all the location(s) that will utilize the Surplus Equipment.
Please use DCAS Surplus Equipment Donation - Organization Location Information Excel template and upload with your location listings. *
Describe how you intend to use the Surplus Equipment. Please include the following in your description:
- Main purpose
- When, where, and how you plan to use it
- How will your organization offer low or no-cost services to the public, if applicable. *
Has your organization received Surplus Equipment donations from the City of New York in the past? *
Yes No
Describe Equipment Donated. *
Provide the date the organization received the donation. * MM / DD / YYYY
Provide a brief statement on how the Surplus Equipment was used. *
If there is any additional information you would like to provide, use the space below.
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