Your donation will benefit: Perception Funding

  • Please complete this form
  • Fill in required information
  • Click on Submit
  • Upon receipt of your form we will email procedures for completing your

We Accept:

  • Cell Phones
  • iPhones
  • iPods
  • iPads
  • Tablets
  • Notebooks
  • Laptops
  • GPS Devices
  • MP3 Players
  • Kindles
  • Nooks
  • PDA’s
  • Pagers
  • Cameras

Please select the specific Perception Funding Fund (required)

Total Number of ALL devices donated (required)

Contact Person (required)

Mailing Address (required)

City (required)

State (required)

Zip (required)

Phone (required)

Email (required)


You will receive an email from confirming your donation. Please add this address as a safe or approved address to your spam filter to ensure successful delivery.

Recycled by:

Integrity Communications