Digital Access Fund Resource Application
If you need an educational resource/school supply that DCTA can help provide for you, please fill out the form!
Read through the resource guide before applying - www.bit.ly/dafguide
Feel free to reach out with any questions by email (dcteensaction@gmail.com) or Instagram DM (@DCTeensAction).
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Name (full name) *
School/College *
If you are an adult/parent, write your child's name and school below
Email (personal, not school) *
If you enter a school-affiliated email address, we will most likely not be able to send messages to it.
Phone number
Optional, for contact purposes
Home Address
Enter if you would like the product shipped/delivered to your house (if not, we can arrange an alternate location for pick-up)
If you live in DC, what ward do you live in? *
If you don't live in DC, write "N/A". If you are not sure what ward you live in, use this link to find out and enter it below. - https://planning.dc.gov/whatsmyward
If you're under 16 years old , please enter a parent/guardian's name, email, and phone number
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