Charge Forward Device Request Form
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? *
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? *
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Do you have access to wired internet at your residence? *
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Which is of greater importance to you in computer? *
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? *
What software do you need capacity to run? (Check all that apply!) *
Required
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