<p> Digital TV: Keeping Seniors Connected Campaign CHECKLIST OF SUPPLIES FOR HOME VISITS</p><p>Consumer Information Packets NOTES  Digital TV transition Fact Sheet/FAQs  Converter box coupon application forms  Nursing home converter box application forms  List of coupon eligible converter boxes  Local directories . Local cable and satellite TV providers . Local retail stores where converter boxes are sold  Local contact who can troubleshoot  ______</p><p>Tool Kit for Home Visits  DTV home assessment form and follow-up action plan  Laptop with wireless connection for online coupon applications (IF AVAILABLE)  Waiver of liability form  Converter box coupon application tracking form  General diagrams and instructions for setting up a converter box  Installation kit (see below)  Troubleshooting guide  Local technical assistance contacts for installers  ______</p><p>Installation Kit  A spare set of AV cables, coaxial wires, coaxial adaptors, twin-lead antenna wires, twin-lead adaptors, antenna “splitters,” A/B switches, and universal remote controls  Power strips and extension cords in various lengths  Electrical tape  Screwdriver  AA and AAA Batteries  ______</p><p>N A T I O N A L A S S O C I A T I O N O F A R E A A G E N C I E S O N A G I N G 1730 R H O D E I S L A N D A V E N U E , NW, S T E . 1200, W A S H I N G T O N , DC 20036</p>