COMPUTERS FOR KIDS

COMPUTER FOR KIDS

Registration form
Our Computers for Kids program provides refurbished, like-new computers to school aged kids free of charge. Fully supported by Craig Clark, a local retired computer tech with a heart for helping, MHM distributes his donated laptops to qualified clients.

Selection of the approved applications is based on need, and our supply of laptops which is limited. If you qualify, we will call you to conduct a brief interview over the phone. If you are selected, you will be given a time for you to come pick up the laptop.

If you do not qualify we will notify you by email within 7 days.
Client's Name*

First NameLast Name
Email*
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County
Phone Number*

Area CodePhone Number
Language spoken*
Please confirm you are a current MHM client.

YesNo
Client number - if known
School age children*
How many school age kids in the household?*
How many computers in the home already?*
Do you have access to WIFI in the home?

YesNo
Name of internet provider
Do you need a printer?

YesNo
Monthly income*

< $999.00$1.000-$2,000$2001--$3,000>$3,000
Reason you need a computer?*

Elementary or Middle SchoolHigh SchoolCollegeWorkGames
Explain why you need a computer and who needs to use it.
Contact Date

MonthDayYear
Date
Scheduled Pick Up Date

MonthDayYear
Date
Computer #
Date Picked Up

MonthDayYear
Date
Photo*
Interview comments
Child's name
Thank you note

Browse Files

Cancelof
Thank you for submitting your application for our COMPUTERS FOR KIDS program. We will need to verify whether or not you are a client of Mothers Helping Mothers.

Please allow us 1 week to process your application.

If you are not a current client your application will be denied and you will receive an email from programs.mhmsarasota@gmail.com.

If you are a current client you will receive a phone from our program coordinator (941-212-3654) to discuss your need for a computer and to determine if you qualify for our program. Please answer the phone if you receive a phone call/text from that phone number.
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COMPUTER FOR KIDS