Welcome to Connect Across Tacoma!

This is the application for free high speed internet and laptops. This is an eligibility based program and this application determines that eligibility.

This form allows for the Tacoma community to self-attest their eligibility for the Connect Across Tacoma assistance program based on the following:

Financial Aid Recipient (e.g., received Pell Grant, Work Study assignment, or other local, state or federal financial aid)
Access to Internet (determined by the Tacoma Equity Index and CMC Qualification)
Household Income (e.g., total household income at or below 80% AMI)
Residency (e.g., residence’s proximity to UW Tacoma)

All of this information will be kept safe and secure, and will only be used to determine your eligibility. Our goal is to provide as much assistance to as many people as we can, with as few barriers as possible. Please answer honestly and provide as much information as you're comfortable with sharing.

Once you have filled out each section you must certify that your answers are true to the best of your knowledge.

If you have any questions about the application, please visit the Connect Across Tacoma website at connectacrosstacoma.com or email us at [email protected].

You must be 18 years old or older to continue. *

I am 18 years of age or older

I am under 18 years old

Part One: Personal Information

This first section is where we collect your personal information, so that we can determine you and your household's eligibility and best ways to contact you. Please answer these questions the best you can, and please provide as much information as you are comfortable providing.

First Name *

Last Name *

Email *

Phone

City *

Zip Code *

Address

Street Address

City

State

Country

Postal code

Captcha

I declare (or certify, verify, or state) that the foregoing is true and correct.