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This form has been created to allow members of the A4 community to apply for an iPad. Funding will come from the community members at large, and funds will be collected through www.ChipIn.com. Members of this group will agree to help those who need an iPad for their Children with Special Needs by agreeing to donate each time we choose a NEW recipient. We intend to run this program for as long as we possibly can, hopefully never ending it. Being a part of this group does NOT guarantee that you will receive an iPad; that is entirely dependent on how long this program runs and how successful we are in gathering donations. However, the more people in the group, the more funds we can raise, and the quicker we can provide even more iPads to special needs families. PLEASE only participate if you can AFFORD to help others by providing a few dollars each month. If you are chosen to receive an iPad, we would expect you to let all of your friends and groups/communities that you may belong to aware of the ChipIn collection site, so that they may also contribute money towards your iPad. Once you receive an iPad, we are trusting that you will continue to support future beneficiaries, and remain part of the community to pay it forward. Each iPad with tax costs approximately $530. If you are chosen as the current beneficiary, you will be required to create your own account at www.ChipIn.com, and A4cwsn will then promote it for you in the community. If you live outside the United States, and the iPad will have to be sent to an international address, the total cost will be increased based on international shipping charges and/or local prices for iPads; this will be will announced when your name is chosen. All recipient names will be chosen at random using an online service that shall be displayed on A4 via video each time this is performed. (This MUST be for your own children)



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