Digital Navigation Interest Form Δ CommentsThis field is for validation purposes and should be left unchanged.Name(Required) First Last Prefered method of contact(Required) Phone call Text message Email Other Preferred method of contact (Phone or Email)(Required)Pronouns(Required)What language(s) are you comfortable communicating in?(Required)Preferred days & times to meet (e.g. Mondays before noon, etc.)(Required)How did you hear about this program?(Required) Friend/Family Organization website Internal referral (e.g., front desk, other staff at this organization) External referral (e.g., partner organization) Advertising/marketing (e.g., flier, online ad, commercial) What Types of technology supports will you need to complete this training(Check all that apply)(Required) Need a device Support using devices Home internet connectivity Digital Skills None What outcome are you looking to gain after completing this training(Required) Communication/ Social Education (Formal or informal) Job search (including resume& online applications) Work and Business (including small business, entrepreneurship, and learning new job skills) Entertainment & Hobbies Access and Manage Services and Benefits (e.g. submit taxes, apply for Shopping (online or research for in-person shopping) Prefer not to say Type of Device – What type of device do you need help with? (select all that apply) *(Required) Smartphone Tablet Chromebook Laptop Desktop I do not have a device
