Eligibility for the Complete Package is contingent on satisfaction of criteria and application approval.

First Name *

Last Name *

Email Address *

Deaf/Hard of Hearing Videophone Number * Enter numerical value only. No hyphens, periods, etc. Ex: 1112223333

SMS (Text) Number *

Zip or Postal Code *

Describe Yourself * UnknownDeafDeaf/BlindHard of Hearing

How will you use our services? * Business UseWork From Home UsePersonal UseAll of the above

Residence Type? * Own HouseRent HouseApartmentRent Room

Current Products Used * Convo DesktopConvo MobileP3 DesktopP3 mobileP70SmartVPSorenson DesktopSorenson mobileSorenson nVP1Sorenson nVP2Z5 DesktopZ5 MobileZ70OneVP Please select all that apply.

Comments

Participants in the program are not required to place VRS and/or point-to-point video calls with ZVRS or Purple VRS. Participants will not be restricted to using ZVRS or Purple VRS service only with the Complete equipment.