Digital Literacy and Internet Interest Survey
* Required
First Name:
*
Your answer
Last Name:
*
Your answer
Phone:
*
Your answer
Address:
*
Your answer
Zip code:
*
Your answer
Email:
Your answer
Age / DOB:
Your answer
Best time to reach you:
Your answer
I am interested in: (check all that apply)
Free evening Computer and Internet Classes (Adult)
Free after-school youth computer classes
Low-cost Internet Options
Open Access Computer hours in the Keyspot Lab
Other:
My computer skill level is:
*
I don't know how to turn on a computer
I can turn on a computer, but I have trouble with almost everything else
I know the basics of how to use a computer but not much more
I understand how to use most of the software but I want to learn more
I completely understand my computer software and hardware
Required
Do you have a computer at home?
Yes
No
Comment:
Your answer
Signature:
Your answer
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