Family Application Technology Support Application FormPlease enable JavaScript in your browser to complete this form.Parent/GuardianName *FirstLastOccupation *Are you a Canadian citizen? *YesNoPermanent ResidentOtherMailing Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryPhone *Relationship to Child *Parent Email *EmailConfirm EmailSecond Parent (If applicable)If no second parent please leave this section blankNameFirstLastOccupationPhoneSection DividerWhat type of school are you currently enrolled in *Online/Hub learningIn school/in person learningOnline- Homeschooling privately OtherChild InformationPlease only apply for one child as we are only able to provide one laptop per household at this time. How many children in homeName *FirstLastChild Birthdate *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender *MaleFemaleSchool 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 UpStudent 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 verificationPlease 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 HousingProof of Income SupportRecent Notice of AssessmentProof of Children's Health BenefitsFour Consecutive Pay stubsCanada Child Benefit Notice -page 1 & 2 most recent tax yearUpload 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 notyesnosingle parentCheckboxes *I have read and agree to the Terms of ServiceCheckboxes *I have read and agree to the Privacy PolicyWould you like to subscribe to our newsletter to be aware of new promotions, contests and more?Yes of course!I love free things!Not right nowSingle Line TextNameSubmit