Who are you?

We need some basic information to be able to serve you. If you are signing up for someone else, you will be able to add their information also. If you are affiliated with an organization that works with people who may use our services, please indicate the organization. If you would rather call us, we can take your information over the phone. Our statewide number is 215-204-1356.

Why do we need this information?

Because most of our work is supported by your tax dollars, we need to be able to show that we are using the funds we are given to actually help the people of Pennsylvania get the tools and technology they need to thrive. We respect your privacy and take security very seriously.