Community Computer Program
Please fill out the form so that your application can be processed. Wait times may vary depending on the number of applicants and the number of available computers. Your patience is appreciated. We value your privacy; your information is kept private and secure. We do not sell or share your data, and we only use it to deliver our services.
Full Name
*
First Name
Last Name
Are you aged 18-35?
*
Yes
No
Do not wish to answer
Do you identify as Indigenous?
*
Yes
No
Do not wish to answer
Street Address (including postal code if known)
*
Street Address
Street Address Line 2
City
Province
Postal Code
Email Address
*
Phone Number
-
e.g. 204
e.g. 777-7777
What is the best way to get in touch with you? (select all that apply)
*
The email address you provided
Phone call - the phone number you provided
Text message - the phone number you provided
Other (please specify)
Please select your preferred pick-up location to attend once your device is ready: (Select one)
*
St. John's Library (500 Salter St - Mon, Tues & Thurs: 12-8pm, OR Wed & Fri: 10am-5pm)
Merchant's Corner (541 Selkirk Ave - Mon-Fri: 9am-3:30pm)
Would you be interested in taking any digital literacy courses to improve your basic knowledge about computers and computer usage?
*
Please Select
YES
NO
What types of topics and/or skills would you be interested in learning about?
We value your opinion. If you have any feedback, comments, or something you would like us to be aware of, please provide here:
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