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Free Access Equipment Application
Thank you for your interest in our program! After the minimum two weeks of the equipment being listed, we will start to contact people. When all equipment is taken, we will turn off form submission.
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* Indicates required question
Email
*
Your email
Your Name
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Your answer
Your Email (for confirmation)
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Your answer
Your Phone Number
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Your answer
Street
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Your answer
City
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Currently limited to South Portland residents only.
Choose
South Portland, yes I can apply for this program.
Not South Portland, no I can not apply for this program.
State
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This program is limited to Maine residents only.
Choose
Maine, yes I can apply for this program.
Not Maine, no I can not apply for this program.
You have read, understand, and agree to the Refurbished Equipment Policies as outlined on our website.
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Choose
Yes, I have read, understand, and agree to the Refurbished Equipment Policies as listed on the website. I can apply for this program.
No, I have not read, understood, or agreed to the Refurbished Equipment policies as listed on the website. I can not apply for this program.
You understand devices come with no tech support or warranty.
*
Choose
Yes, I understand there is no tech support or warranty.
No, I do not understand, please do not consider me for this program.
Pick Up
*
Choose
If selected, I understand and am able to pick up my device from the SPHS Main Office during school operating hours.
I can not pick up my device, and will be unable to apply for this program.
2021-2022 Income Brackets
Please use the table above as guidance to determine your student’s economic status. If your household income is less than the income amounts for your household size in the chart below, then your student meets the economic disadvantaged status criteria. Household size includes adults and children.
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Household Meets Category 1 Guidelines
Household Meets Category 2 Guidelines
Household income is higher than the income amounts in the charts above and my student does not meet the criteria for either category 1 or category 2.
Child First Name
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Your answer
Child Last Name
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Your answer
Child School
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Choose
Brown Elementary
Dyer Elementary
Kaler Elementary
Skillin Elementary
Small Elementary
Mahoney Middle
Memorial Middle
South Portland High School
Do you have another child?
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Yes
No
If yes, please list your other child(ren) and their grades/schools.
Your answer
Free device application
*
Choose
Please consider me for the free device application. I understand I will be contacted via email if selected or added to the wait list.
Please do not consider me for the free device application. I do not wish to apply.
A copy of your responses will be emailed to the address you provided.
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