Construction On Ramp Interest Form
Thank you for your interest in the Construction On Ramp Program, previously known as the Construction Sector Bridge Program! The information collected in this form will be kept confidential and will only be used to complete your CityBuild Academy application file.
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Client Information
First Name *
Last Name *
Best way to contact you? *
Please provide your cell phone number. *
Please provide your email. *
What is your zip code? *
Do you have a CA Drivers License?
Clear selection
If you answered that you are in the process of completing, please elaborate here. Share if you have a permit, if you have a scheduled test at the DMV, etc.
Do you have access to your Social Security Card / Social Security Number?
Clear selection
What high school do / did you attend?
What is your Date of Birth?
MM
/
DD
/
YYYY
Will you be 18 by May 22, 2022? *
Demographic Information
Providing demographic information is optional. It is used for reporting and statistical purposes only.
Gender
Clear selection
How do you identify your ethnicity? Please select boxes that apply.
Clear selection
Do you identify as any of the following?
Sexual Orientation
Clear selection
School Enrollment
Clear selection
Educational Attainment
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Are you vaccinated?
Clear selection
Thank you for filling out this interest form!
This last question helps us determine the most effective outreach methods.
How did you hear about our program? *
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