Silver Cosmos Workshop Interest Form
Welcome to Golden Cosmos Consulting! We're thrilled you're here.
Below is an initial interest form for our Silver Cosmos Technology Basics Course. There is no obligation or cost associated. We're excited to bring this course to your community and we're gauging potential interest in future courses, so please share your thoughts with us!

While you can can always check out our main page at www.goldencosmosconsulting.com to see what we're doing with schools, districts, and universities, we're really excited about our newest venture - Small Town Tech - where we bring our expertise and know-how into close-knit communities and help build skills and comfort around technology with the hope that we will spark a sense of confidence, curiosity, and community. 

We won't share your data with anyone; this information is just to help us craft the best experience for our participants. 


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First Name *
Last Name *
Phone *
Mailing Address *
Email Address  *
What's the best way to reach you?
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Our May 2nd Workshop in Breckenridge, TX does not have availability. Are you interested in future workshops in Breckenridge and the surrounding area? *
Are you in need of a registration sponsorship? These spots are highly limited and are dependent on our current sponsor donations. You may be placed on a waiting list until a sponsorship becomes available if you select this option.  *
What type of device will you be bringing to your session? *
Required
What do you currently use your device for? For example: texting with friends, checking email, checking weather, video calls, social media, browsing the internet, shopping, etc. *
On a scale of 1 to 4, how confident do you feel using technology in your daily life? *
Not at all
Pretty Good!
What would you most like to learn to do with your devices? (Choose your top 3 for now) *
Required
What would you say is your biggest barrier to feeling confident and comfortable with your technology tools? *
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This form was created inside of Golden Cosmos.