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Apply for a Computer

Important Notice: All allocations are based on availability. Completing an application does not guarantee you will receive a computer.

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Parent/Guardian Name

First

Last

Parent/Guardian Email

Parent/Guardian Phone

School or Program Your Students Attend

Names and Ages of Children in the Home

the Phone proof

Shipping Address

If selected to receive a computer, we will request proof of income documentation. Which of the following types would you be able to provide?

Current household income
Food Support (e.g. WIC, SNAP) (a dated letter showing current eligibility is required)
Financial Assistance such as TANF, etc. (a dated letter showing current eligibility is required)
Medicaid or Medical Assistance
The National School Lunch Programs / Free or Reduced Lunch Program
Section 8 / Federal Public Housing Assistance / Group Residential Housing (GRH)
Section 42 Low Income Housing Tax Credit unit or other HUD low income program
Social Security Disability (SSD)
Supplemental Security Income (SSI)
Federal Pell Grant
Other

NextDesk Project