Technology Needs Assessment and Remote Learning Application

Thank you for your interest in classes and devices from PEC's Center For Digital Inclusion and Technology.
PEC is offering free, remote computer trainings remotely in online group settings.

Temple University and People's Emergency Center are also working together to provide refurbished computers to families in West Philadelphia for use in their online computer skills trainings.

If you have any questions about the form, please email
First Name *
Last Name *
Email Address
Phone Number *
Home Address *
Household Size *
# of Adults in Household *
# of K to Grade 8 Students in Household *
# of High School Students in Household *
Names of school(s) your child(ren) attend
How many functioning computers/laptops do you have have in the house now? *
Which of the following companies is your internet provider? *
Do you currently have a WiFi connection in the home?
If you received a computer for your household, would you need help setting it up?
Do you already have a device you plan to use for remote classes?
Have you previously used Zoom, Skype, or similar video call software to connect with others?
What topics are you interested in learning more about, related to your computer and or other devices? Please list a few topics to get started. We will be working with computer recipients to create personalized learning plans. These can cover whatever technology topics you're interested in and will be designed to fit your schedule and needs. *
What is your typical availability during the week for weekly remote learning?
Morning (10am - 12pm)
Early Afternoon (12pm - 3pm)
Late Afternoon (3pm - 5pm)
Evening (5pm - 8pm)
How did you hear about this opportunity? (Mailer, friend, coworker, flier, other?) *
Comments / Questions:
Zip Code *
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