Mobile Technology Lab (MTL) Request Form
Connect.DC's Mobile Technology Lab (MTL) is a portable, Internet-ready computer lab providing free computer and Internet access to the general public, especially in areas with limited Internet access. We partner with District government agencies and nonprofit organizations interested in bringing the power of technology to District neighborhoods. Please take a few minutes to describe your event and how you would like to use the MTL.
1) Name *
Enter the name of the person making the request.
Your answer
2) Organization *
e.g., Please list the name of your agency, nonprofit organization, faith-based organization, civic association, business, etc.
Your answer
3) Event *
Your answer
4) Description *
Please describe your event, including your intended audience, in 1-4 sentences
Your answer
5) Date(s) *
Please use following format: MM/DD/YYYY
Your answer
6) Start Time *
Please use following format: 12:00pm.
Your answer
7) End Time *
Please use following format: 1:00pm.
Your answer
8) Location *
Please list the street address for your event.
Your answer
9) How many people are expected to attend this event? *
10) What types of activities would you like to have on the MTL? *
10 a) Point of contact (POC) Name *
Please provide the name of the point of contact for the event.
Your answer
10 b) POC Email Address *
Enter the email address of the point of contact for the event.
Your answer
10 c) POC Phone Number *
Please use following format: 202-000-0000
Your answer
11) Is this your first time requesting the MTL? *
12) Would you be interested in partnering with Connect.DC in the future? *
13) Do you have constituents who would be interested in discounted Internet and computer offerings? *
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