Are You a Refugee?
Network Atlanta Community Technology
Application for Computer
1. Name:
2. Address:
3. City, State Zip:
4. Phone:
5. Email:
6. Are you a Refugee? Yes No
What is your date of arrival?
What refugee agencies do you work with?
7. Are you disabled? Yes No
8. Are you age 55 or older? Yes No
9. Do you receive any government assistance? Yes No
What kind?
What is your income?
How many persons in your family?
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If you are not receiving any government assistance, you must meet these income guidelines:
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Persons in Family
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1
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2
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3
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4
|
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Annual Income
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$20,036
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$26,954
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$33,874
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$40,792
|
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Persons in Family
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5
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6
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7
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8
|
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Annual Income
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$47,712
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$54,630
|
$66,540
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$74,020
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To be eligible for a computer you must answer yes to question 6, 7 or 8 or 9. You may qualify anyway if your income falls within the income guidelines (National School Lunch Program) in question 9 or you live in a technologically disadvantaged community. Non-Profit organizations are also eligible to receive computers.