Simplify Tech Workshops

Select the Session from the Drop-down and Submit your registration

Email: connect@.jersimglobalinc.com Website: www.jersimglobalinc.com

Sign in to Google to save your progress. Learn more
Select Event Date *
On a scale of 1-5, how would you rate your current comfort level with technology?
Very uncomfortable
Very comfortable
Clear selection
Full Name *
Email *
Phone *
Which specific topics or areas within 'Technology Information and Tips' are you most interested in?
Questions, Comments or Feedback
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of jersimglobalinc.com.

Does this form look suspicious? Report

Google Forms