ConnectUp Interest Form
Please complete the form to join ConnectUp and be paired with a ConnectUp Coach!
Sign in to Google to save your progress. Learn more
Email *
Last Name, First Name
What are your preferred pronouns
Clear selection
Is this your first year at Las Positas College?
Have you attended any colleges outside of the Chabot/Las Positas Community College District?
What is your educational goal at Las Positas College
Clear selection
If you selected a major, please provide it below or type 'undecided'. *
Enter your phone number *
Is it okay to send a text message to the phone number that you entered?
What is the best way to contact you?  Make sure your prefered contact information is captured in this form. If not, please use the last question to clarify your preferred contact information.
Enter any other contact information that you want us to have?  You can also share anything else you want us to know that will help us pair you with a ConnectUp Coach.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy