New Member Interest Form

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Thank you for demonstrating interest in enrolling your youth at the Boys & Girls Club of San Fernando Valley! Please fill out the form to move forward with the enrollment process. This form consists of two parts. Please read carefully. The information provided here will only be seen by the Membership Director and FIT Program Manager if applicable.

-11251 Glenoaks Blvd. Pacoima, CA 91331 -Office (818) 896-5261 -www.bgcsfv.org

Email *

Parent/Guardian Full Name *

Address *

Phone number *

New Member Full Name and Age *if more than one, separate with a comma *

What school are they attending? *if more than one, separate with a comma *

Preferred date and time for a call back/appointment *

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