Group Program Intake Form

1

Organization Information

Organization Name *

Organization Type *

City & State *

Organization Website (if any)

2

Your Contact Information

Your First Name *

Your Last Name *

Your Title / Role

Phone Number *

Email Address *

3

Your Community

Approximate Number of Members / Participants

Average Age of Your Community

How would you describe your community's current technology comfort level?

Complete beginners Some basic experience Mixed levels Moderate experience

What are the biggest technology challenges your community faces? (Check all that apply)

4

Program Interest

What type of program are you interested in?

How many participants do you expect per session?

Do you have a preferred format?

In person at our location Virtual (Zoom) Hybrid Flexible

Do you have a rough timeframe in mind?

5

Budget & Additional Details

Note: We offer flexible pricing and can work within a variety of budgets. Sharing your range helps us create the best proposal for you.

Do you have an approximate budget in mind?

How did you hear about AI4Every1?

Is there anything else you'd like us to know?

Group ProgramIntake Form