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Application For a Computer
To APPLY for a Home Computer – Child must be between the ages 6-17
Is the applicant the legal guardian?
Yes
No
Is the household income under $26,000.00?
Yes
No
Do you own a computer?
Yes
No
Do you have Internet already?
Yes
No
Can you arrange for delivery of your computer?
Yes
No
Why are you applying for a computer?
2
+
6
=
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