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After School Program Application
To apply for computers for your after school program, please fill out the information below. If you need help complete this survey, please email apply@RRRcomputer.org.
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Email
*
Your email
RRRcomputer.org
Date
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MM
/
DD
/
YYYY
Name of responsible person for after-school
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Your answer
Title
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Your answer
What is your school's name?
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Your answer
Street
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Your answer
City
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Your answer
State
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Your answer
Zip
*
Your answer
Phone
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Your answer
How many student are enrolled in the after school program?
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Your answer
How many of the students in the after school program receive free lunch?
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Your answer
What grades attend the after school program?
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Your answer
How many computers does your school currently own for your after school program?
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Your answer
How many computers does your after school program currently need and want to get?
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Your answer
In a short paragraph, please describe how getting the computers would help with your educational program?
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Your answer
Please submit a 2 minute video to apply@RRRcomputer.org of how we can help. We may use the video for promotional purpose.
*
Yes, we can do that.
No
How soon do you need the computer?
*
Your answer
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