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Mobile Lab Rockford Request
Mobile Technology Lab is a portable, Internet-ready computer lab providing free computer and Internet access to the general public, especially in areas with limited Internet access. We partner with other agencies and nonprofit organizations interested in bringing the power of technology to the Rockford community. Please take a few minutes to describe your event and how you would like to use the Mobile Lab.
New Mobile Learning Lab Launches in Rockford
1) Name
Enter the name of the person making the request.
Your answer
2) Organization
e.g., Please list the name of your agency, nonprofit organization, faith-based organization, civic association, business, etc.
Your answer
3) Event
Your answer
4) Description
Please describe your event, including your intended audience, in 1-4 sentences
Your answer
5) Date(s)
Please use following format: MM/DD/YYYY
MM
/
DD
/
YYYY
6) Start Time
Time
:
7) End Time
Time
:
8) Location
Please list the street address for your event.
Your answer
9) How many people are expected to attend this event?
10) What types of activities would you like to have on the Mobile Lab?
Required
10 a) Point of contact (POC) Name
Please provide the name of the point of contact for the event.
Your answer
10 b) POC Email Address
Enter the email address of the point of contact for the event.
Your answer
10 c) POC Phone Number
Please use following format: 815-000-0000
Your answer
11) Is this your first time requesting the Mobile Lab?
12) Would you be interested in partnering with the Mobile Lab in the future?
13) Would you be interested in partnering with the Mobile Lab in the future?
14) Do you have constituents who would be interested in discounted Internet and computer offerings?
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