Charlotte County Digital Literacy
Pre registration form
Preferred Location *
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Name (First Name, Last Name) *
Your answer
Address with Postal Code *
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Home Phone Number (including area code) *
Your answer
Cell Phone Number (including area code)
Your answer
Gender *
Birthdate *
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Mother Tongue *
How did you learn about our program? *
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Employment Status *
Learner Objectives *
Please select any of the following that may affect your progress:
Educational Level *
Last Grade Completed *
Digital Literacy Skills You Want to Learn? *
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