Essential Families

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Essential Broadband Pilot
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Essential Broadband Pilot

Need a Laptop Computer and Internet?

Essential Families has FREE Laptop Computers and Assistance Selecting the Best Internet Service Provider!

Register Below or Call 816.839.5814 For Registration Assistance

04/01/2023

First Name

Last Name

Address

City

State

Zip code

Gender
MaleFemaleTransgenderGender not listed

Mobile Number

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Mobile Number

Email Address

User Password*

Confirm Password*

Race Ethnicity

Number of People in Household

Household Annual Income

Do you have a child(ren) enrolled in child care?
YesNo

Please add the address of your child care provider?

Please provide the name of your child care provider

Please provide the phone number of your child care provider

What is your weekly child care payment?

Do you have medical insurance?
YesNo

Do you have any of the following devices?
TabletLaptopDesk Top ComputerCell phoneNone of These

Do you have access to the Internet?

YesNo

Who is your internet provider

Do you have a late bill with the company that provides your internet?

YesNo

If yes, what is your current balance:

Are you getting any discounts on your internet bill, like the Affordable Connectivity Program?

YesNo

Did you use it for your cell phone service?

YesNo

Does your child qualify For Free or Reduce lunch at school?
YesNo

Do you have a Lifeline phone (also known as a government or Obama phone)?

YesNo

Do you participate in any of these government programs?

Free or Reduced School LunchSSISNAPTANFNo

How would you rate your computer/internet skills?

BeginnerIntermediateExpert

Are you willing to attend computer and Internet training?

YesNo

Do you have car?

YesNo

Computer and Internet training available dates

Click to schedule best time for you

Do you need help working with your child or children?

YesNo

Do you need to speak with someone about your problems?

YesNo

Outreach/Contact Consent By providing your mobile phone number, and email address, you consent to receive periodic Essential Broadband Pilot and other community awareness text messages, telephone calls using an automated telephone dialing system with prerecorded message from 3rd Wave Marketing, or its clients. Reply STOP to be removed from text campaign. Press 3 to be removed from automated telephone dialing system. Message and data rates may apply.

Please check box to confirm your permission and understanding

Report a Problem

Registration

Children and Families Registered 69 of 69

Waiting listing: 115

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Digital Navigator
ACP Internet Access Assistance
Laptop computer
Computer and Internet Training
Virtual Parental Education
Virtual Mental Healthcare
EveryThing- Essential Local Resources, at your fingertips!
NoW Video Conference
Z Trip (transportation)
Child Care Payment Assistant
Digital Workforce Development (which includes, Digital Navigator, AWS Linux Software Developer, Remote Digital Marketing Specialist, and Virtual Home Visitor training)

All Essential Families programs are measured in “Real Time” and Data is reported in “Real Time” to Funders, Donors, Families, and Providers.

The Essential Broadband Network Pilot registration begins November 14, 2022, with services starting in December 2022.

63934 Individuals/Families Helped

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