Coalition Member Registration
Register your organization for Digital Inclusion Awareness Day.

Saturday, July 15, 2017
9 a.m.- 12 p.m.
Mohart Multipurpose Center
Multipurpose Room, #121
3200 Wayne Ave
Kansas City, MO 64109

This free event is to raise awareness for the importance of digital inclusion and help community members get signed up for low-cost internet, computer classes and affordable computers. So join us and bring your signup sheets, informational handouts and other promotional materials. Just let us know you're coming by completing the short form below.

Email address
Name
Your answer
Name of your organization/agency/business
Your answer
Do you want table?
Tables are available for you to set up displays and literature about your organization. However they are limited so please help us plan accordingly.
Indicate your table preference:
Would you like to make a donation on behalf of your organization for the raffle?
The details you provide may be used in promotional materials/announcements.
Will you make a donation to the raffle?
If yes, please describe your donation.
Your answer
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms