Qualification Certification

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We sell Windows PCs to those that qualify for our program, and require a visual confirmation to serve as verification.  Please check off those programs you participate in that make you eligible for our service.

☐ Medi-Cal

☐ CMSP

☐ Healthy Families

☐ EBT Food Stamp Card

☐ Section 8 Housing

☐ Have a child in school receiving Free or Reduced price lunch

☐ AT&T lifeline – phone bill

☐ PG&E Star program – reduced utility fees

☐ SMUD – (EARP) Energy Assistance Program Rate

☐ College Students on Financial-Aid

☐ Fire victim with Red Cross assistance letter

☐ Veteran with Veteran’s Administration card

☐ Social Security Disability

☐ Senior aged 65 or older

☐ Non-Profits with 501(c)(3)/IRS Letter

 

I certify that I am participating in at least one of the above listed programs.

  • I am purchasing this computer system for my own use and not for resale.

Name (Printed)________________________________________________________________________

Signature:_____________________________________________________Date:___________________

 


If you don’t qualify for a Windows PC after reviewing this certification document, please contact us to inquire about “specials” PC sales.