This form provides us with the information the National Digital Equity Center needs to get a tablet to a resident of the Age Friendly Communities of the Lower Kennebec and help them take the digital literacy classes they need to successfully use it.
This referral form is designed so that you can refer a resident over the phone or while sitting with them in person. Please make sure they know that they will receive a call from the National Digital Equity Center to go over the End User Agreement and ask them further questions to enroll them in our program. If you can, as a trusted member of their community, please complete the Enrollment Registration form at www.digitalequitycenter.org/enroll with them and put “Age Friendly Communities of Lower Kennebec” in the space provided at the top of the form.
Before completing the referral form below, please make sure that you have completed their Enrollment form with them and they have agreed to the End User Agreement. If you or they have any questions, please contact us at firstname.lastname@example.org before completing the Enrollment Process.