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Mobile Internet
Training
(Bridging the gap between our golden years and technology)


Sign Up Form!

Are you ready to get started? Use this quick form to express your interest and one of our "Mobile Internet Training" Representatives will contact within 24 hours.

Click here to contact us with your questions and or concerns!

Should you experience trouble completing this form and or have further questions and or concerns you may call us at (770) 465-4000.



Select the number of seniors you would like to schedule training for:
1 to 5
6 to 10
11 to 15
16 to 20
21 to 25
26 or more



Select the number of days for training:
1
2
3
4

Select your preference for class training:
Mornings
Mid-Day
Afternoon
Saturday


Select the days of the week you would like your classes to be schedule:
Monday's
Tuesday's
Wednesday's
Thursday's
Friday's
Saturday's
Other

Select the training session you would like to register your seniors to attend:
Introduction to the computer
Internet Class - 1
Internet Class - 2
Online Banking
Other



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Please select first and second choice to begin classes:
Please input a date:
Please input another date:


Additional training or assistance needs (Please explain):


Comments (Optional):




Name:

Company:

Phone:

Fax:

E-Mail:

Address:

City:

State:
Zip Code:

Select Class: