Fill This form below to submit your application for a Free Government Tablet. First Name* Last Name* Date of Birth* Contact #* Last 4 of SSN* Email* Address* What Kind of Assistance Do You Have?MedicaidSNAP / Food StampsSSIVeterans Pension and Survivors BenefitFederal Public Housing Assistance (FPHA)Bureau of Indian Affairs General AssistanceReceived a Federal Pell Grant in the Current award yearFree and Reduced-Price School Lunch Program or School Breakfast ProgramSpecial Supplemental Nutrition Program for Women Infants and Children (WIC) Apply Now
