REQUEST A NEW ACCOUNT

Please fill out the form below and click the "Create Account" button to request a new AT4Maine account. Just remember, passwords must be no less than six characters and must contain at least one alpha character and one numeric character. Fields marked with a are required.

Personal Information

First Name:

Last Name:

Address Line 1:

Address Line 2:

City:

State:

Zip:

Phone Number 1:

(Example: 888-888-8888)

Phone Number 2:

Phone Number 3:

Account Information

Email:

Verify Email:

Password:

Verify Password:

Password Clue:

Clue Answer:

I am a:

How did you hear about us?

New Account Agreement Terms

Agreement Terms:

Welcome to AT4Maine, a free statewide service for Maine people with disabilities who may have assistive technology needs, their families, service providers, schools, and agencies. AT4Maine is a resource where you can browse assistive technology demonstration or loan. Before looking at our web site, please take a moment to review the guidelines for accessing and using our site. Please also note that the individual programs that provide demonstration and loan have specific and individual policies and procedures. While selecting assistive technology, it is very important that you involve the appropriate professional to help you choose the right assistive devices. For example, an occupational therapist and/or physical therapist can assist you when choosing mobility aids such as standers, wheelchairs. A Speech-Language Pathologist can assist you when choosing augmentative communications devices. If you are under 18 years of age, an adult must be involved in this process. All personal information listed (email address and/or phone number) is intended for AT4Maine use only. AT4Maine is prohibited from selling or distributing this information to other sources.

I AGREE to these termsI DO NOT agree to these terms

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