Surplus Application User Information

Please fill out the following information for your Department. You will receive an email with your user information within 24 hours.

Department Name: Division Name: Information Technology Equipment Donation (what's this?) Main Address: Street:   City:   State:   Zip: Main Phone Number: ( ) - Administrator Name: Work Email: Job Title: Password: Direct Phone Number : ( ) - Fax Number: ( ) - Main Department Administrator Name: Main Department Administrator Phone: ( ) -