Name of your organization: Your Full Name: E-mail address: Confirm e-mail: Phone number: Address: Are you a registered charity? Yes No You are not required to be a registered charity to apply. Are you a religious organization? Yes No Both religious and non-religious organizations are welcome to apply.. Are you looking for a pre-built arcade or kit? Pre-built Kit Either Are you open to accepting a refurbished or scratch/dented unit? Yes No These may be customer exchanges, floor models, etc.., but will all be in excellent condition.. Reason for request: What will the arcade be used for? Comments: Please note this form is not encrypted. If you are not able to submit this form please copy and paste into an e-mail and send it to: donations@dreamarcades.com