Technology Request Form

Student Information

(Eight digit Banner ID)
Must be your Tunxis email (must end with .edu).
Register BEFORE submitting this form.

Request

Employee spouses and children may be ineligible for technology loans.
If you require accessibility software for a disability, please indicate that here.
Need free or affordable Internet access at home?
If you or someone in your household received a Federal Pell Grant this school year (part of student financial aid) or meet other qualifications such as being enrolled in SNAP, Medicaid, WIC, or other programs, then you likely qualify for the federal government's Affordable Connectivity Program.  Apply for this benefit at getinternet.gov.
Students must be in good standing academically and financially. If approved for technology, I understand I am responsible for returning it in the same condition it was received and in a timely manner. If damaged, I accept responsibility for repair or replacement costs.
The college has a very limited number of technology items. Students close to graduating or taking a large number of credits will be given preference.
Check the box below to indicate your understanding and acceptance of terms.