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* Your full name
   
 
 
 
* Your current email address (this needs to be your own private email address)
   
 
 
 
Choose your college from the list below (click on the down arrow to see the list, then click on your college). If you do not see your college in the list, contact your MESA director.
 
 
 
Do you have your own computer? Check all that apply.
 
Desktop computer (less than 2 years old)
 
Desktop computer (more than 2 years old)
 
Laptop or netbook computer (less than 2 years old)
 
Laptop or netbook computer (more than 2 years old)

 
 
How do you usually connect to the internet.
No internet access Dial-up DSL or broadband
(high speed access)
Cable/satellite
/radio
Cell phone
provider
Don't know
Home
Dorm
Work
Laptop
Other mobile device
 
 
 
Any comments or further information you would like to share with your MESA director about the California Connects program and your need for a laptop?
   
 
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