Enrollment Interest Form

Interested in enrolling or know someone who may be interested? Fill out this form and we will contact you with more information on enrolling at one of our 16 school sites. Required fields marked with an asterisk *

Contact Information

First Name*

Answer Required

Last Name*

Answer Required

Are you a potential student looking to enroll or are you filling this out on behalf of someone else?*

Answer Required

I'm a potential student looking to enroll.

I'm a parent/guardian of a potential student looking to enroll.

I am a counselor/social worker/advocate of a potential student looking to enroll.

Other:

If you are filling this out on a potential student's behalf, what is the student's name? (Leave blank if you are a potential student filling this form out for yourself.)

Answer Required

What is your email address?*

Answer Required

What is your phone number?*

Number Required

What is the age of the student looking to enroll?*

Answer Required

What is the zip code of the student looking to enroll?*

Answer Required

What is your preferred method of communication?*

Answer Required

Phone Call

Text

How did you hear about YouthBuild Charter School of California?*

Answer Required

Our 16 campuses offer a variety of different job training and work experience opportunities. Check any that may be of interest to the potential student:

Answer Required

CAMT (Certified Apartment Maintenance Technician) Training

Construction Training

Culinary Arts/ Hospitality Training

Environmental/ Conservation Corps

Film/ Creative Arts

Music/ Recording Arts

Paid work experience opportunities

Support with finding a job or internship

Other:

If you have any questions for us or want to provide any more details about yourself, you may include them below.

Answer Required

Please fix the highlighted areas below before submitting.

Enrollment Interest Form