Editing previous response:

Please fix the highlighted areas below before submitting.

Lennox Site/ SBWIB YouthBuild - Enrollment Interest Form Copy

Please fill out this form if you are interested in enrolling at YouthBuild Charter School of California's site at SBWIB YouthBuild in Lennox. Required fields marked with an asterisk *

Contact Information

First Name*

Answer required for "First Name"

Last Name*

Answer required for "Last Name"

Email Address*

Answer required for "Email Address"

Phone Number*

Number Required

How would you like us to contact you?*

Answer required for "How would you like us to contact you?"

Phone Call

Text

How old are you?*

Answer required for "How old are you?"

What is your zip code?*

Answer required for "What is your zip code?"

Is there anything you'd like to share with us about why you want to enroll?

Answer required for "Is there anything you'd like to share with us about why you want to enroll? "

Confirmation Email

Answer required for "Confirmation Email"