Corona-Norco Adult School Device Request
Please complete this form.  We will contact you by email or phone when your device is ready to pick up.
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Email *
First Name: *
Last Name: *
Date of Birth (to verify enrollment) *
Phone Number: *
Please Confirm Email Address: *
Do you have access to WiFi? *
Are you enrolled in a class at Corona-Norco Adult School? *
Which class(es) are enrolled in?
Do you have children attending school in the Corona-Norco Unified School District?
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If yes, which school(s)?
Thank you!  We will be contacting you by email or phone with information about picking up your device.  
A copy of your responses will be emailed to the address you provided.
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