Fill out this form and a member of our team will contact you to get started.
First Name *
Last Name *
Phone * What is the best number to reach you?. Please enter numbers only in format 9999999999. .
The number is... My Cell Phone My Home phone (landline) A friend or relative's cell phone A friend or relative's home phone (landline) Other:
Email (optional)
Birthdate * mm/dd/yyyy (example: 01/15/1999)
Do you have a high school diploma? * Yes No
If No, What is the highest grade level you have completed? [select..] 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade
Are you presently enrolled in High School? * Yes No
Last High School Attended (Enter current high school if presently enrolled above): [select..] Alameda HS (Alameda USD) American HS (Fremont USD) Amos Alonzo Stagg HS (CONS HSD 230) ARISE Charter (OUSD) Bay Area School of Enterprise (Alameda City USD) Berkeley Adult School (Berkeley USD) Berkeley HS (Berkeley USD) Berkeley Technology Academy (Berkeley USD) Black Diamond HS (Pittsburg USD) Castlemont HS (OUSD) Community Day School (OUSD) Conley Caraballo HS (New Haven USD) David Douglas HS (David Douglas SD) De Anza (WCCUSD) Deer Valley HS (Deer Valley USD) Del Sol HS (Las Vegas, NV) (Clark County School District) Destrehan HS (Louisianna) (St. Charles Parish School District) Dewey Academy (OUSD) Downtown HS (San Francisco USD) East Union HS (East Union Community SD) Edward Shands Adult School (OUSD) El Dorado HS (Arkansas) (El Dorado Public SD) Elmhurst Middle School (OUSD) Emery Secondary (Emeryville USD) Excel HS, McClymonds (OUSD) Far West HS (OUSD) Fremont HS (OUSD) Gompers HS (WCCUSD) Granada HS (Livermore Valley Joint USD) Hayward Adult School (Hayward USD) Hayward HS (Hayward USD) Health Professions HS (Sacramento ) Independence HS (Liberty Union HSD) Island High Continuation School (Alameda USD) John Adams Center (San Francisco USD) Kennedy HS (Fremont USD) Life Academy HS (OUSD) Live Oak HS (Morgan Hill USD) MacGregor HS (Albany SD) McClymonds HS (OUSD) Merrill F. West HS (Tracy USD) Mount McKinley School (CCCOE) Oakland HS (OUSD) Oakland Technical HS (OUSD) Oasis HS (OUSD) Other - not listed (Other) Pinole Valley HS (WCCUSD) Pittsburg HS (Pittsburg USD) Quest Academy (ACOE) Right of Passage Charter HS (EDCOE) Rudsdale Continuation School (OUSD) San Leandro Adult School (San Leandro USD) San Leandro HS (San Leandro USD) San Lorenzo HS (San Lorenzo USD) San Lorenzo Valley HS (San Lorenzo USD) Serra Adult School (WCCUSD) Siatech-Treasure Island Job Corps (Vista USD) Skyline HS (OUSD) Sojourner Truth Independent Study HS (OUSD) Southeast Community College (San Francisco) Sunset Center Adult School (Hayward USD) TAP Center (OUSD) Tennyson HS (Hayward USD) Tracy Adult School (Tracy USD) Tracy HS (Tracy USD) Trinity Whitewater Community Day HS (Banning USD) Unity HS (OUSD) Vista HS (WCCUSD) West Contra Costa Adult Education School (WCCUSD) William Daylor HS (Elk Grove USD) Xcel Academy School (San Francisco USD) Youth Empowerment School (YES) (OUSD)
If Last High School Attended is not in the list above, please enter it here:
Do you have a driver's license? * Yes No
Which program are you interested in signing up for today? (select all that apply):* Academy high schoolConservation internshipRecycling apprenticeshipNot sure. I would like to learn more.
Have you ever attended Civicorps before? * Yes No I have interviewed but not attended.
What is your Preferred Language? ¿Cuál es su idioma preferido?
How did you hear about Civicorps? [select..] Facebook Flyer Met a recruiter at an event Friend or Family Member Case Worker Probation Officer School Counselor Other Google Instagram Snapchat LinkedIn Twitter Mailchimp YouTube TDB - Partner Channels Website TikTok BART ad