JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
The Makers Hub:
Home Systems Registration Form
Register now for our upcoming workshop and secure your spot! Don't miss this opportunity to learn valuable skills, connect with experts, and join a community of like-minded individuals. Fill out the form below to reserve your seat and be part of an engaging and informative workshop that can help you enhance your knowledge and achieve your goals. Limited spaces available, so sign up today!
Please note that this workshop is open to Compton residents only per HUD funding rules
. If you are not a Compton resident, you will not be able to attend this workshop.
Regístrate en Español
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Eligibility.
For this workshop, you must meet the required income requirements. Please refer to the chart below and indicate whether or not your household income is at or below the limit.
*
Yes, my household income is at or below the limit.
No, my household income is not at or below the limit.
Name.
First Name.
*
Your answer
Name.
Last Name.
*
Your answer
Phone.
Phone number.
*
Your answer
Age.
How old are you?
*
Your answer
Address.
Are you a Compton resident?
Please note that this workshop is
only
open to Compton residents per HUD funding rules
. If you are not a Compton resident, you will not be able to attend this workshop.
*
Yes
No
Ethnicity/Race.
Please provide your ethnicity/race.
*
African American or Black
Hispanic or Latinx
Native American/Indigenous
Asian
White
Other
Household Size.
Please provide the number of people in your household.
*
Your answer
Female Head of Household.
Please provide the name of the female head of household.
Please note that the female head of household indicates the h
ousehold in which an adult female is the sole or main income producer and decision-maker. If there isn't a female head of household please put N/A.
*
Your answer
Total Household Income.
Please provide the total income of your household.
Please note that due to HUD funding rules, you will have to submit proof of income in order to be eligible for the free tool kit and Compton Tool Library membership. You can find
Eligible Income Sources below.
*
Less than $20,000
$20,001 - $40,000
$40,001 - $60,000
$60,001 - $80,000
$80,001 - $100,000
More than $100,000
Disability.
Do any members in your household have a disability?
*
Yes
No
The Makers Hub Newsletter.
Would you like to receive The Makers Hub Newsletter? Please note that you can unsubscribe at any time.
*
Yes
No
The Makers Hub Introduction.
How did you hear about The Makers Hub?
*
Choose
Social Media Ad
Social Media (not an ad)
Facebook Group
A friend/family member
TMH Staff or Volunteers
A flyer
Other
Additional Information.
Please add any additional information or details.
*
Your answer
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of The Makers Hub.
Report Abuse
Forms
