Intake Form

Thank you for your interest in the Techquity Device Program! This program is here to help adults who do not have a computer at home. To get your no-cost device, please fill out the form below.

Here’s what you need to receive your device today:

  1. Please fill out the form below, completely.

  2. Have a photo ID with your name.

  3. Do not share/post any links or your registrations details with others. Only people who are registered (through this event - with their name) will get a device.

Full Online Experience Coming Soon…