PowerUp USA Program Application

Empowering Adults, Seniors, and Youth with 21st century creative and digital skills. Classes will held at 933 Louise Ave #101 Charlotte, NC, 28204 (Hygge - THE HUB) on Zoom or at various locations throughout North Carolina

Full Name

Email

Phone

Address

City

State

Country

Postal code

Choose the programs that interest you

Youth

Digital Seniors

Adult Literacy

Technology Support

Will you be bringing your own Laptop? ( We suggest you bring your own laptop.) If not we have a limited number for your use.

Yes

No

Which way are you attending this class?

In-Person

Virtually

What is your level of computer experience?

None

Basic

Med-Level

Experience

Do you have any accessibility needs?

Yes

No

List Accessibility Needs?

Race

African American‎

Asian American‎

Caucasian American‎

Latino American‎

For all Adults, please answer the following questions for our grant

Employed‎

Self-Employed‎

Retired‎

Unemployed‎

Hourly Wages

Under $16 per hour‎

$16 - $20 per hour‎

Over $20 per hour‎