Roaring Riptide - FRC Team 4118 - #FIRSTwithAT - Request & Connections Portal
If you’re interested in finding an Assistive Technology maker near you, or want to request a specific project for us to work with you on to support, we will do our best to help!
Complete this form and our FIRST Robotics Coach will contact you with 7 business days! if you'd like to send a follow up email, you can email our Coach, Leigh Anne Brewster at labrewster@pky.ufl.edu
Your Name *
Your answer
Best Contact Phone Number *
Your answer
Your Physical Address *
Your answer
Email Address *
Your answer
Your School District, Current Workplace Location, or Other Background Assistive Technology Interest Information *
Your answer
How did you find out about our Assistive Technology request form? *
Description of the specific problem that you believe AT, the Maker Movement, or a FIRST robotics team may help to address . What is the diagnosis/limitations you/your patient have? Do you have any ideas or specific limitations for the project you are looking for? *
Your answer
What is your anticipated or expected timeframe for completion of this project? *
Your answer
Do you have additional questions or concerns that you would like to speak with us about after we receive your request?
Your answer
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This form was created inside of P.K. Yonge Developmental Research School.