Donation Request

I would like to apply for a sponsor to get my internet-capable device properly filtered.

    Name (required)

    Email (required)

    Phone Number

    What type of device are you looking to filter?

    Do you already have GenTech installed on your device?

    YesNo

    What is your GenTech username?(Skip if you aren't a customer yet)

    What office location serviced your filter?(Skip if you aren't a customer yet)

    Is there anything that you'd like to tell us?