MBC-Power Up Philly Laptop Sign-Up

Power Up Philly Laptop Sign-Up – Monumental Registration
Monumental Baptist Church has been allotted 35 laptops through the City of Philadelphia’s Power Up Philly initiative.

Available for:

- Seniors (62+)
- Youth (Ages 13–18)
- First come, first served.
- Must meet eligibility requirements and be present on Saturday, March 28, 2026 (10AM–4PM).
- Transportation provided from Monumental to the venue and back.

Registration closes Sunday at 12:00 PM (noon).
CONTACT INFORMATION
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
AGE CATEGORY
Registering As:*

Seniors (62+)Youth (13-18)
Are you a resident of Philadelphia?*

YesNo
Thank you for your interest. Seniors must be residents of Philadelphia to qualify.
Does the youth attend a Philadelphia school?

YesNo
Youth must attend a Philadelphia school to qualify.
Parent/Guardian Name*
Parent/Guardian Phone Number*
Please enter a valid phone number.
ELIGIBILITY SELF-ATTESTATION

Eligibility is self-attested. No documentation required.
Eligibility Confirmation*

I am currently enrolled in an income-based government assistance programMy household income is under 200% of the federal poverty level
TRANSPORTATION
Transportation Needed?*

YesNoNot sure
MONUMENTAL CONNECTION
Are You a Member?*

YesNo
Would You Like Updates from Monumental?

YesNo
FINAL CONFIRMATION
By submitting this form, I understand that:

• This opportunity is first come, first served
• Submitting this form does not guarantee a laptop
• I must complete the official City registration after this form
• I must be present on March 28, 2026 to receive the laptop
I confirm that I have read and understand the above conditions.*

I Confirm
Should be Empty:

Power Up Philly Laptop Sign-Up – Monumental Registration

CONTACT INFORMATION

AGE CATEGORY

ELIGIBILITY SELF-ATTESTATION

TRANSPORTATION

MONUMENTAL CONNECTION

FINAL CONFIRMATION