Name *

First Name

Last Name

Do you have an email address? *

Yes, I have an email address (please add it below)

I don't have an email and would like to set one up.

I don't have an email and don't want one now.

Phone *

(###)

###

####

Tell us what technology you have.

iPhone

Android Phone

iPad

Tablet (Samsung, Microsoft, etc.)

Apple (Mac) Computer

PC Computer

Other

I don't know

What is your comfort level with technology?

Beginner (I don’t know how to navigate my device(s) well)

Intermediate (I can navigate my device(s), but not much else)

Expert (I am pretty skilled at using my device(s))

To better assist you, do you have any accessibility constraints that we can help you address with your technology? Please check all that apply

Vision

Hearing

Mobility

What would you like to focus on during your initial Get Started Session?

Something's not working

I want to learn Zoom

I want to learn how to FaceTime

I want to learn how to use my device better

Other