TECH CORPS Unplugged Request Form
TECH CORPS believes there is a need to ensure students with limited and/or no internet access still have an opportunity to participate in high-quality computer science learning experiences, especially during these difficult times. As such, we have created an unplugged experience that introduces students to computer science without using computers.

TECH CORPS Unplugged is designed to Educate, Excite and Empower students with the “T” in STEM. Each kit will include unplugged lessons, supplies and swag! Through these engaging activities, students will learn about topics ranging from algorithms to virtual reality. The lessons and activities can be used alone or with siblings and family members. In addition to computer science concepts, students will learn valuable 21st-century skills such as teamwork, innovation, problem-solving and critical thinking.

To qualify for a kit, students must live or attend school in one of TECH CORPS' program areas (listed below).

Families are able to request one kit on behalf of a student in their household, and TECH CORPS will ship it to the address provided in this form or deliver the kit to a local program service provider while supplies last.
Which TECH CORPS Region are you located in? *
Student First Name: *
Student Last Name: *
Student Gender: *
Student Grade (Fall 2020): *
Student Ethnicity (only used for reporting purposes): *
School Name (Fall 2020): *
School District: *
Parent/Guardian First Name: *
Parent/Guardian Last Name: *
Street Address: *
City: *
Zip Code: *
Parent/Guardian Phone Number: *
Parent/Guardian Email Address: *
Number of adults in your household (indirectly impacted by TECH CORPS Unplugged): *
Number of children in your household excluding the student listed above (indirectly impacted by TECH CORPS Unplugged): *
Is there a computer (i.e. desktop, laptop, Chromebook) in the house? *
Is there internet access in the house? *
Next
Never submit passwords through Google Forms.
This form was created inside of TECH CORPS. Report Abuse