12 Days of Christmas Laptop Application Form

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We are excited to give away 12 Chromebooks to individuals that are in need of one over the holidays. Please fill this form out no later than November 22nd to be considered. Please make sure you answer the final 2 questions in detail to be considered. To learn more about HTI, please visit https://hubzonetech.org

*Please note if you submit this form, you will be willing to take a picture receiving your laptop and allowing us to post this on social media as well as some information about your story. We will speak to you directly prior to any posting.

Name *

Email address *

Telephone Number *

Are you a student, veteran, unemployed and/or underemployed? *

Student

Veteran

Unemployed and/or Underemployed

Required

Please tell us about yourself (where do you live, what are your hobbies, are you affiliated with any organizations)? *

In 200 - 500 words tell us how you will use a Google Chromebook (this will be the most important factor when choosing our recipients) *

Submit

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