Partnering To Create Disruptive Strategies To Close The Digital Divide Across the United States

Email (207) 259-5010

Primary Menu

Search

Email (207) 259-5010

Maine General

Please complete this form for each person you refer to the Maine General Tablet Program.

Name of Provider Making Referral*
First Last
Name of Individual Needing Tablet*
First Last
Best phone number to reach this person*
If this person has email, please enter it here:
Does the person being referred have internet access at home?
- Yes
- No
- Not sure
If none or insufficient internet access, they will receive a data tablet. If high speed access, they will receive a wireless tablet.
Please describe this person's familiarity with Android tablets/phones?
- Very experienced; will need little to no assistance
- Some experience; may need some assistance
- This is their first tablet or device
How much assistance will this person need with Zoom?
- No need for assistance; enrolled in Internet Safety class
- May need initial assistance; enrolled in Internet Safety
- Will need an Individual Learning Plan
Are there any limitations for this person that you would like the tutor to be aware of in assisting them with their device?
Please provide the name and phone number of a family or friend that can be contacted if we cannot reach the recipient about their tablet?
Is there anything else you wish us to know about this referral?
If the USPS address is different than the residential address, please enter it here.
Street Address City State
Please confirm the residential address for this recipient?
Street Address City State
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Δ

Home
About Us
Affordable Device Program Data Tablet Agreement
Affordable Device Program Desktop Agreement
Affordable Device Program Laptop Agreement
Affordable Device Program Pro Laptop Agreement
Affordable Device Referral Program
Age Friendly Communities of Lower Kennebec Tablet Program
Class Survey
Contact Us
Create A Digital Literacy Program
Create A Local Broadband Benefit Program
Dempsey
Digital Equity
Digital Inclusion
Digital Literacy
Digital Literacy Instructors Needed -Apply Now!
Enroll
Free Computer Skills Classes!
How Can We Help?
Ina Beal
Join Us!
Learn About Affordable Broadband
Maine Digital Inclusion Initiative
Maine General
Marita L. Fairfield
MCF Referral Form
MDDC
MDII Out Of State Enrollment
National Digital Equity Center Named NDIA National Digital Navigator Corps Grantee
NDEC Affordable Devices Program
NDEC Class Evaluation Form
NDEC Code of Conduct
NDEC Maine Impact
NDEC News
Online Teaching Survey
Online Tutoring Program
Our Maine Programs
Partner Onsite Class Survey
Partner Onsite Classes Program Request
Susan Corbett
Susan’s Corner
Tablet Program Survey
Tablet Subscription
Upcoming Classes
Resources
Embedded Map Test