Level Up Program Registration

We're thrilled you are interested in signing up for the Level Up Program! Once your application is submitted, expect an email confirmation from the Program Manager.  If you have any questions about Level Up or the application, please email info@socalcan.org
*Please note that form cannot be saved, you will need to complete application in one sitting. 
General Information

High School Information

Demographic Information  
Completion of the following questions will not affect your involvement in the program or the terms and conditions of your involvement.

College Information

College Information


Student Profile

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