Computer Program Application Form
Summer 2021 / Online classes
All information provided on this form is confidential and is used by staff only.
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Email *
Applicant's Full Name *
Date of birth *
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Gender *
Country of Origin *
Current address *
Email address *
Telephone number *
Write the full name of an emergency contact *
Emergency contact phone number *
The City of Austin gives our program funding for clients who have minimal income. Please write the names and birthdates of yourself, your spouse/partner, and any child under 18. Please answer the questions in the last two columns for each person listed. *
(Write the name of your partner and children living with you at home) Example: Esther Smith: Wife, Eduardo Smith: son, Carlos Smith (son)
Highest level of education completed *
Are you currently working? *
Required
If you are currently working, how many hours a week do you work? *
Have you taken classes at Manos de Cristo before? *
Do you have internet access in your home? *
Do you own a computer? (It can be a desktop, laptop or a Chromebook) *
Do you have experience using any of the following: *
Required
Are you interested in purchasing a low-cost computer or Wifi hotspot? *
Choose your preferred schedule: (we cannot guarantee that your preferred schedule is available)
Monday and Wednesday
Tuesday and Thursday
9:30 am - 11:30 am
6:30 pm - 8:30 pm
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