Connector Application

Jborhood LBC Community Connector Interest Form

Thank you for your interest in creating a microcommunity through our new Jborhood program! Please complete the form below to apply for a role as a Jborhood LBC Community Connector. Click here for the Connector job description.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Interfaith FamiliesFamilies with School Age ChildrenEmpty NestersYoung Adults (under 40, no kids)VolunteerismWidows/Widowers40s/50s SinglesLocation Based Group (IE: La Mirada, Seal Beach, Bixby Knolls)Other
If you selected "Other" or "Location Based Group" above - please elaborate here:
Should be Empty:

Jborhood LBC Community Connector Interest Form