Please enable JavaScript in your browser to complete this form.Name *FirstLastAddress *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Email *Birth-Date *Ethnicity *Black/African AmericanCaucasianHispanicAsianOtherSex *MaleFemaleEmergency Contact Person *FirstLastEmergency Contact Phone *Have you ever been convicted of a felony? *YesNoMentor Leader assignment:Classroom Aid for Character TraitsKitchen Food or Snack ServerLeader Floater- Bus MonitorYouth Project Assistant-Assist youth with projectsSelect all that apply.Skilled Trades / Educator Assignment:Culinary Art Assistant-Assist youth with recipesSkilled Trades- ElectricalSkilled Trades- PlumbingSkilled Trades- CarpentryFacilitate activties (Keep youth engaged)PhotographerChef-InstructorTeacher-Character Traits ClassSelect all that apply.Have you ever done any volunteer work before? If yes, tell us about your experience *Do you have any particular skills or qualities that your could use in your volunteer work? *How did you hear about our program? *Week 1- I can volunteer on: *MondayTuesdayWednesdayThursdayFridaySaturday STEM Project (12:00 -2:00 PM)Unavailable this weekWeek 2- I can volunteer on: *MondayTuesdayWednesdayThursdayFridaySaturday STEM Project (12:00 -2:00 PM)Unavailable this weekWeek 3- I can volunteer on: *MondayTuesdayWednesdayThursdayFridaySaturday STEM Project (12:00 -2:00 PM)Unavailable this weekWeek 4- I can volunteer on: *MondayTuesdayWednesdayThursdayFridaySaturday STEM Project (12:00 -2:00 PM)Unavailable this weekPlease select your T-shirt size ? *Small AdultMedium AdultLarge1X Large2X LargeDrivers License NumberExpiration DateSubmit