Family APplication

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Technology Support Application Form

Parent/Guardian

Name *

First

Last

Occupation *

Are you a Canadian citizen? *

Yes
No
Permanent Resident
Other

Mailing Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone *

Relationship to Child *

Parent Email *

Email

Confirm Email

Second Parent (If applicable)

If no second parent please leave this section blank

Name

First

Last

Occupation

Phone

Section Divider

What type of school are you currently enrolled in *

Online/Hub learning
In school/in person learning
Online- Homeschooling privately
Other

Child Information

Please only apply for one child as we are only able to provide one laptop per household at this time.

How many children in home

Name *

First

Last

Child Birthdate *//

Gender *

Male
Female

School Name *

Please enter the name of the school your child attends.

Grade *

What grade is the child in?

Parent Explanation (Describe your situation in full detail) *

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

Student Essay *

Please take a moment with your child(ren) 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

Report Card Upload *

Click or drag a file to this area to upload.

Most recent copy of report card (last year or semester is fine)

Income verification

Please attach a copy of one or two of the 6 documents. The more information you can give us, the quicker the process will be. NOTE : INCOME VERIFICATION FOR **BOTH PARENTS** IN HOUSEHOLD NEEDED YOU WILL BE AUTO REJECTED WITHOUT THE CORRECT DOCUMENTS

What will you be attaching? *

Proof of Subsidized Housing
Proof of Income Support
Recent Notice of Assessment
Proof of Children's Health Benefits
Four Consecutive Pay stubs
Canada Child Benefit Notice -page 1 & 2 most recent tax year

Upload your documents here *

Click or drag files to this area to upload. You can upload up to 5 files.

Did you upload BOTH parents income requirements? Your application may be declined if not

yes
no
single parent

Checkboxes *

I have read and agree to the Terms of Service

Checkboxes *

I have read and agree to the Privacy Policy

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Yes of course!
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