Student street address (include apt. #) for delivery of device. *
Your answer
City *
Your answer
Zip *
Your answer
School of attendance *
Your answer
Do you have a school issued device? *
If you have a school issued device and it is not working, what are the issues? *
Required
What type of technology do you need? *
Required
Tell us about your device situation/story and what you need. *
Your answer
Please share the name of a teacher, dean, or administrator at the school who is aware of your need for a device and can verify that you need a school device. *
Your answer
How are you learning? *
Do you have another working device to use until you get a school issued device?