HBIU YEP PROGRAM
PLEASE CONTACT US AT *(Yep@hib.university)*
The HBIU Youth Empowerment Training Program is a "FREE" year round program, for young adults in the Greater Hartford Community age 17-24. We intake new students quarterly. Programs are run for 3 Months with graduation and Job fair to help students retain employment. 
YEP
Last Name *
First Name *
Town Code *
Zip Code *
Home Phone
Cell Phone
Work Phone
DOB (Birth Date) *
MM
/
DD
/
YYYY
Age *
State Assigned Student Identifier (SASID) for anyone 18 and under
School if applicable *
Email Address *
Complete Address: Street, City, State, and Zip *
Chose the program your interested in  *
What do you want to accomplish from this training ? *
Please print giving your child permission to to participate in the 3 month training program
( Parent must sign for anyone under the age of 18 )
(if applicable)
I verify that I am between19-24. Checkbox *
I agree to comply with the guidelines of the HBIU Youth Empowerment program *
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