Caseworker Application

Community Support Application Form

Representative

Child Information

Please only apply for one child as we are only able to provide one laptop per household at this time.
Please enter the name of the school the child attends.
What grade is the child in?
Please be as detailed as possible on what you are using for school work (this could be a laptop, tablet, write and take pictures, etc.. ) And WHY you feel your family could benefit from having a device from Step Up
Please take a moment with your student and have them type a paragraph on how they think a laptop will help them learn.

Student Verification

Please attach a copy of students most recent report card to verify students school and grade
Click or drag a file to this area to upload.
Most recent copy of report card (last year or semester is fine)
Click or drag files to this area to upload. You can upload up to 5 files.