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Digital Inclusion Center at Pitt’s Community Engagement Center in the Hill District Sign-Up
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
*
Your answer
Email
*
Your answer
Phone Number
Your answer
Gender Identity
*
Male
Female
Prefer not to say
Other:
Ethnicity
*
Hispanic or Latino
White
Native American or American Indian
Asian / Pacific Islander
Black or African American
Other:
Do any of the following apply to you? Check those that do.
*
I am recently unemployed/out-of-work
I do not have access to a computing device other than a smartphone (desktop, laptop, Chromebook, tablet, etc.)
I do not have consistent internet access
None of the above apply
Required
My current income is:
*
between $0 and $50,000 per year
above $50,000 per year
Prefer not to answer
What age group do you best fit into?
*
K thru 2nd grade
3rd thru 5th grade
6th thru 8th grade
High school student
Adult
Senior citizen
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