Tech Goes Home Community Class Application

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Completion of this application does not guarantee acceptance into this course. This class has capacity for 10 participants. We will launch additional online classes throughout the year.

Tech Goes Home Chattanooga strives to ensure that all residents are provided with the tools, training, and access to support 21st century skills development. TGH CHA welcomes members of every race, religion, ethnicity, sex, gender, sexual orientation, ability, and veteran status.

Class Information
1. Class will meet every Wednesday, starting May 25th and ending June 29, EXCEPT June 15th, from 6pm to 9pm in person at the Edney Innovation Center. (Class dates: 5/25, 6/1, 6/8, 6/22, and 6/29)
2. You must complete every class session in full.
3. Failure to complete all class requirements will result in you having to return your Chromebook to Tech Goes Home. Your co-pay will NOT be refunded.
4. You will be notified of your acceptance into the course no later than Monday, May 23rd.
5. In order to be eligible for a class, you must be at least 18 years of age.

Email *

Name (First and Last) *

Gender *

Female

Male

Prefer not to say

Other:

Ethnicity *

American Indian or Alaskan Native

Asian

African American or Black Non-Hispanic

Latinx

Native Hawaiian or Pacific Islander

White Non-Hispanic

Other:

Primary Language *

English

Spanish

Other:

Birthdate *

YYYY

Zip Code *

Contact Phone Number *

Educational status (select highest level completed) *

Grade 0-8

Grade 9-12 (non-graduate)

High school diploma or GED

Some college / AA

College graduate

Post graduate

Employment Status *

Part-time

Full-time

Unemployed

Retired

Approximate Annual Household Income *

Under $4,999

$5,000-$7,499

$7,500-$9,999

$10,000-$14,999

$15,000-$19,999

$20,000-$29,999

$30,000-$39,999

$40,000 or more

Current Employer (if applicable)

Job Title / Position (if applicable)

Do you have home internet? *

Yes, EPB

Yes, Comcast

Yes, AT&T

Yes, other provider

No, I have no home internet access

How would you rate your computer skills? *

Beginner (Little to no experience)

Expert

I have read and agree to all the requirements. The applicants understand that any information provided to TGH CHA is subject to use and disclosure by TGH CHA at its sole discretion. TGH CHA will be guided by what it determines to be in the best interests of and to benefit TGH CHA. (Please type your full name as your digital signature and to indicate your agreement). *

I hereby give the unqualified right to the Tech Goes Home Chattanooga (TGH CHA) program to take pictures and/or video of me. I give permission for these images as well as materials that we have created in the TGH CHA program to be used in print and web-based publications. The TGH CHA program will put these images to legitimate use without limitation or reservation. *

Yes

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