Application for Video Game Donations

Would the kids in your care love video games?

Hi! This is Shelly with Fully Loaded Electronics. Through our Gift of Gaming program, we are working with a donor who wants to donate gaming systems to children's hospitals and clinics all across the US and Canada. Please fill out this brief questionnaire if you're interested!
1.Your Name
2.Your Organization
3.Your Phone Number
4.Your Email Address
5.How many patient encounters does your hospital have each year? "Patient encounter" means any contact from a flu shot to a surgery, and you may encounter the same patient multiple times in a year. An estimate is great.
6.The Xbox Series S comes loaded with about 12 popular kids games and the internet is deactivated. How many Xboxes would you like to request?
7.The Nintendo Switch comes loaded with about 12 popular kids games and the internet is deactivated. How many Nintendo Switches would you like to request?
8.PlayStations are a little hard to get these days, but you're welcome to request them and we'll sure try. We can do a used PS4 or a new PS5. Either console comes loaded with 12 popular kids games, and the internet is deactivated. How many PlayStations would you like to request? Please specify PS4 or PS5.
9.Who would use these gaming systems, and how would having these gaming systems impact your patients, their families, and the staff at your organization?
10.How many kids would use each gaming system per day?
11.How will you thank the donor? This donor has been very generous and has received painfully few acknowledgements so far. It's kinda sad. I'm hopeful we can find requestors who will go the extra mile to get a video of the unboxing, video of a kid playing the video games for the first time, or at least photos and testimonials that will help the donor raise more funds so they can donate to even more hospitals. How do you plan to thank the donor?
12.If you receive this donation, what address would you like it shipped to? We need the Hospital/Clinic name, Department, Contact Person & their phone number, Street Address, City, State & Zip.
13.Do you have any questions for me?
That's it! We will take a look at your request and probably call you with a couple more questions. As soon as we have everything we need, we will put your request in front of the donor. This donor tends to approve/edit requests pretty quickly. If this donor does not approve your request, we have other donors we can talk to. Would you like to ask me some questions? Feel free to email me, Shelly@FullyLoadedElectronics.com, or call me M-F 9am to 5pm Pacific time at (425) 582-3173. Thank you for your request!