Application

    Please note that the information obtained in this application is kept confidential and is shared only with YouthBuild Staff.  Information is complied for state reporting purposes.  You are to answer all questions on this application.  If you do not fully complete the application it will result in a delay in the processing of your application.  This will delay your enrollment into YouthBuild Columbus Community School.  If the question does not apply to you place N/A in the appropriate box. 

    Date of Birth

    Contact Information

    Please complete the following information in order that we may contact you.  Contacts could include mother, father, sister, brother, grandmother, grandfather or other relatives.  You must provide at least two (2) contacts.
    Contact 1
    Contact 3
    Contact 2
    Contact 4

    Education

    Please list the last three high schools you have attended and dates beginning with the most recent:

    Ohio Graduation Tests

    Medical History

    Personal Interest

    Family Information
    Please provide the following information regarding your child or children.  If you do not have any children, please skip this section.
    What are their names, ages, and relationship to you?
    Criminal Justice System
    If you answered yes to being on supervised probation or parole, you are to provide the names and telephone numbers of your probation/parole officer(s):

    Before click the submit button, please be sure that all of your information is complete and accurate.  You will still need to provide the school with the appropriate enrollment documents as outlined on the enrollment page.  You will also need to fill out the request for records document and the free and reduced lunch document, which can be downloaded and printed on the enrollment page.

    By clicking this submit button, you are acknowledging that the information included in this application is complete and accurate.  Your information will not be shared or sold to anyone outside of YouthBuild Columbus Community School.  YouthBuild Columbus Community School holds high standards for privacy when it comes to student information.  If you have any questions or concerns, please contact the school at (614) 291-0805. 
YouthBuild Columbus Community School does not discriminate on the basis of race, religion, gender, nationality, age disability or ethnic background.
*YouthBuild submits to random Drug Testing