Charge Forward Device Request Form

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If you need a computer in order to achieve greater things, fill out this form and Charge Forward will get to work.

Due to current COVID-19 Complications, we are unable to maintain your anonymity, however if this is not an issue for you, please leave a method for us to contact you (email or phone) here.

What is the name of the school you attend? *

Currently, what kind of device(s) do you use for schoolwork? *

Desktop Computer

Laptop Computer

Tablet

Phone (iPod)

None

Required

Do any of the above devices belong to you, if so, which ones? Do any belong to your immediate family members? *

Do you have access to Wifi at your residence? *

Yes

Not Sure

My place of residence is not consistent

Do you have access to wired internet at your residence? *

Yes

Not sure

My place of residence is not consistent

Which is of greater importance to you in computer? *

Power

Mobility

Not Sure

Do you have a desk or table where you sit and work or do you sit on a couch, on a bed in your room, the floor, etc? *

Desk/Table

Other (couch, bed, floor, etc.)

What software do you need capacity to run? (Check all that apply!) *

Chrome Suite (Google Docs, Slides, Sheets, Youtube, etc.)

Microsoft Suite (MS Word, PowerPoint, Excel, Publisher, etc.)

Adobe Suite (Adobe Premier, Photoshop, Creative Cloud)

Other:

Required

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