Teen STEM Volunteer Educator

 
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1. First Name
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2. Last Name
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3. Address:
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4. City:
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5. Zip Code:
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6. Home Phone:
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7. Cell Phone:
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8. Email:
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9. Best time to be reached:
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10. Age:
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11. Grade in Fall 2014 (must be entering 10th grade or above):
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12. School:
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13. Why are you interested in being a STEM Educator for the Library?
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14. What skills or abilities do you bring to this position?
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15. Please describe experience you have working with children.
Volunteer Experience
16. Organization:
17. Type of work performed:
18. Length of time at organization:
Work Experience
19. Employer:
20. Date employed:
21. Business address:
22. Position:
23. Length of employment:
Personal Reference
24. Reference name:
25. Reference phone:
26. Reference address:
School/Business/Volunteer related reference:
27. Reference name:
28. Reference phone:
29. Reference address:
In case of an emergency:
30. Emergency contact name:
31. Emergency contact phone:
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32. Teen STEM Educators will be leading programs at various library locations. Please check all of the locations for which you are interested and available:
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33. Training to be a Teen STEM Educator is required. Please check the date you will attend training:
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34. If I am younger than 18, I understand that this volunteer position requires the signature of a parent or guardian before I can begin.