Each year we receive many requests from organizations who are interested in including our connectors in their project.  Our goal is to fulfill as many as possible.  Only one (1) request will be granted per organization, per calendar year. 

If your donation request is approved, please be aware that we may not be able to provide you exactly what you asked for. We will contact you regarding our decision within 10 business days from receipt of your completed form. Processing times will be extended over the holidays. 

* Date:
How did you hear about us?
Why did you choose Anderson™ connectors?

Do you have any of the following dedicated to the team? Please provide all links that you have.

Educational Website:
Any other sites of published links:
* What part number(s) and how many of each are you interested in? Part numbers can be found on the data sheets in each product section of our website. Please keep in mind we do NOT sample, donate or discount tooling. If you would like to purchase tooling, our customer service department can help you.
Can you supply us with images of our connectors in concept and then in actual use?

Will you list us as a supporter on any of the following:

Program Brochures:
Other (please specify):
* Do we have permission to use any information, images and videos that you supply us or that we take off of any of your sites to promote our partnership in the project, in print or electronically on our website and social media?
* Print you name to agree:

Registered Trademark Usage

Website, Electronic and Printed Materials

- Use the ® or ™ symbol at the most prominent use of the trademark (typically in a header) - use of the ® or ™ symbol must be repeated on every separate page in which the trademark appears. If a header is not being used, use the ® or ™ symbol on the first occurrence of the trademark in text.

- Use the proper attribution language at the bottom of each page - (website/electronic and/or print) for each trademark or image being used.

Combination use: If using a logo, a trademark (for example SB®), and a product image, the following statement must appear on the same page: "© 2018 Anderson Power Products, Inc. All rights reserved. APP® SB® and the APP Logo are registered trademarks of Anderson Power Products, Inc."

Please sign that you have read our trademark guidelines and will adhere to our requests:
* Print you name to agree:
What is the link to the competition you are participating in?
What is the name of your project?
When do you need the parts?

Ship to Address

* Street Address:
* City:
* State:
* Zip Code:
* Country:

Your Contact Information

* Name:
* University/School:
* Street Address:
* City:
* State:
* Zip Code:
* Country:
* Phone:
* E-mail:
If you have any additional information you would like to submit, please list below: