Individual TECHquity Grant Application
This is the Individual application for the TECHquity grant. All grant awards will be in the form of the requested tech items, not grant funding. 

When you submit this form, a copy of your submission will be sent to the email you listed. This email may go to SPAM, so please check there if you do not see it in your main inbox. 

We will be reviewing the applications on a monthly basis beginning in February 2024 and ending in December 2024. Applications will be accepted until November 8, 2024. 

Grantees will be notified no sooner than the 3rd week of every month.

If you would like help filling out this form, please contact Maureen Damrel  408.314.5032  (text or call) or Maureen@destinationhomesv.org. Thank you for your interest.
Sign in to Google to save your progress. Learn more
Email *
Have you received a Techquity grant in the past 12 months? *
Applicant's First and Last name *
Applicant's email address *
Applicant's phone number *
Name of the program and organization where you are engaged in supportive services. Example) Rapid Rehousing with HomeFirst *
Name of a staff member who supports you from the program or organization answered above *
Support staff member's email *
What technology are you requesting?  *
If you chose Other in the question above, what is the technology item you had in mind? 
For COMPUTER requests: We have new HP laptops on hand that we can get to you faster than if you were to pick a different computer from our order form. Would you prefer one of these computers or would you like to be sent the order form?
Clear selection
How will this item/ technology help you? *
Are you currently living outdoors or in temporary housing (a shelter/THU/program with a date set when you will have to leave)? This question is to identify a need for a solar power source to charge your tech item.  *
Are you interested in receiving emails about free technology resources or resources specific to lived experience of homelessness in Santa Clara County?  *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Destination Home. Report Abuse
Google Forms