Registration

Please complete your registration below. All fields marked with an * are mandatory.

• Please complete this required field.

  Please enter a properly formatted email address.

  Your email address may not be used to register. If you believe you have received this message in error, please contact support.
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  Please enter only letters, apostrophes, dashes, or periods
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  Please enter only: letters, numbers, apostrophes, dashes, periods, commas, and ampersands
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• I am a: *

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  • Student
  • Parent/Guardian
  • Student and Parent/Guardian
  What County do you live in? *

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  Please select San Bernardino County Riverside County Other County
  What grade are you (or your student) in? *

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  Please select K-5 6-8 9-12 18-22/Adult Transition Program Out of high school Parent
  What gender do you identify as? (OPTIONAL)

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  Please select Female Male Other Decline to State
  What is your race/ethnicity? (OPTIONAL)

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  • American Indian or Alaska Native
  • Asian
  • Black or African American
  • Caucasian
  • Hispanic or Latino
  • Native Hawaiian or Other Pacific Islander
  • Other
  Which teacher is bringing you to Journey to the Future? *

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  How did you hear about Journey to the Future? *

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  Please select Teacher Social Media Other
  After high school, I (my student) plan(s) to: *

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  • Attend a Vocational Training Program (SOE/CTE)
  • Enroll in a 2-year Community College
  • Enroll in a 4-year California State University College
  • Enroll in a 4-year University of California College
  • Enroll in a Private College
  • I don’t plan on attending college at this time
  After high school, I (my student) plan(s) to: *

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  • Work part-time (less than 20 hrs a week)
  • Work full-time (more than 20 hrs a week)
  • I don’t plan on working

• Profile Image

  If you wish, you may upload an image from your computer that will accompany your profile and user listings within the system (.jpg or .png format, maximum file size 1MB).

  

  Choose a File

  
  Please upload only .jpeg or .png image files.

• TERMS

  The personal data you provide will be used to register you for an event. By completing this registration form, you accept the Terms & Conditions for Journey to the Future and the Participant Terms for 6Connex.

  Yes, I understand that my information will be processed and shared with the aforementioned parties in order to process my registration.

  No, I do not want my information processed and shared with the aforementioned parties and understand I will not be registered.

  You must accept the Terms & Conditions.