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SBCUSD EXL Program Voucher Request
Please answer all the questions below and someone will reach out to you.
8
Questions
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1
Student Name
*
This field is required.
First Name
Last Name
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2
SBCUSD Student ID (Lunch Number)
*
This field is required.
Please Enter Numbers Only
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3
SBCUSD School
*
This field is required.
Select One
Please Select
Alessandro
Allred
Anton
Arrowhead
Arrowview
Arroyo Valley
Barton
Belvedere
Bing Wong
Bonnie Oehl
Bradley
Brown
Burbank
Cajon HS
Chavez
Cole
Curtis
Cypress
Davidson
Del Rosa
Del Vallejo
Dominguez
Emmerton
Fairfax
Golden Valley
Gomez
Gomez Development Center
Henry
Highland Pacific
Hillside
Holcomb
Hunt
Indian Springs HS
Inghram
Jones
Kendall Complex
Kimbark
King
Lankershim
Lincoln
Lytle Creek
Marshall
Middle College
Monterey
Mount Vernon
Muscoy
Newmark
North Park
North Verdemont
Norton
Paakuma
Pacific HS
Palm
Parkside
Richardson
Riley
Rio Vista
Roberts
Rodriguez
Roosevelt
Salinas
San Andreas HS
San Bernardino HS
San Gorgonio HS
Serrano
Shandin Hills
Sierra HS
Thompson
Urbita
Vermont
Warm Springs
Wilson
Please Select
Please Select
Alessandro
Allred
Anton
Arrowhead
Arrowview
Arroyo Valley
Barton
Belvedere
Bing Wong
Bonnie Oehl
Bradley
Brown
Burbank
Cajon HS
Chavez
Cole
Curtis
Cypress
Davidson
Del Rosa
Del Vallejo
Dominguez
Emmerton
Fairfax
Golden Valley
Gomez
Gomez Development Center
Henry
Highland Pacific
Hillside
Holcomb
Hunt
Indian Springs HS
Inghram
Jones
Kendall Complex
Kimbark
King
Lankershim
Lincoln
Lytle Creek
Marshall
Middle College
Monterey
Mount Vernon
Muscoy
Newmark
North Park
North Verdemont
Norton
Paakuma
Pacific HS
Palm
Parkside
Richardson
Riley
Rio Vista
Roberts
Rodriguez
Roosevelt
Salinas
San Andreas HS
San Bernardino HS
San Gorgonio HS
Serrano
Shandin Hills
Sierra HS
Thompson
Urbita
Vermont
Warm Springs
Wilson
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4
Student Grade
*
This field is required.
Select One
Please Select
TK
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
Please Select
Please Select
TK
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
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5
Program Interests
*
This field is required.
Check all that apply.
Swim Lessons - San Bernardino YMCA
Swim Lessons - Highland YMCA
Summer Day Camp - San Bernardino YMCA
Summer Day Camp - Highland YMCA
Sports - San Bernardino YMCA
Sports - Highland YMCA
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6
Parent's Name
*
This field is required.
First Name
Last Name
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7
Parent's Email
*
This field is required.
example@example.com
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8
Parent's Phone Number
*
This field is required.
Area Code
Phone Number
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