Computer Classes
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Age
Phone Number *
Email address (Optional) If you have one.
When are you available? *
Required
Specific date (Please give at least 24 hours notice)
How confident do you feel about doing the following tasks without any help?
Send an email *
Not at all confident
Very Confident
Look for Information online (using a search engine) *
Not at all confident
Very confident
Complete an online form
Not at all confident
Very confident
Clear selection
Please tell us how strongly you agree or disagree with the statement below
Overall, I am confident in my ability to use the Internet *
Strongly disagree
Strongly agree
Select all services you're interested in *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of bcpl.org. Report Abuse