Office of the Provost
University Laboratory High School
St. Elmo Brady STEM Academy Student Volunteers Sign-Up
1. First Name
2. Last Name
3. What is your student status?
University Laboratory High School student
Undergraduate freshman
Undergraduate sophomore
Undergraduate junior
Undergraduate senior
Graduate student
4. Major/Department (Uni High students, write "N/A")
5. Race/Ethnicity (please mark all that apply)
American Indian or Alaska Native
Asian
Black or African American
Caucasian
Hispanic or Latinx
Native Hawaiian or other Pacific Islander
Other
Enter text
6. Gender
Female
Male
Non-binary
Another gender
Enter text
7. Email address
8. Phone number
9. Are you generally available 9:00 - 11:00am on Fridays from late February to mid-April?
Yes
No
Other
Enter text
10. Which of the following volunteering roles are you interested in? (Check all that apply)
ACTIVITY ASSISTANT: Helping Booker T. Washington students with STEM activities from 9-11am on Fridays
ACTIVITY LEADER: Leading STEM activities for Booker T. Washington students from 9-11am on Fridays
ACTIVITY PLANNER: Planning STEM activities for Booker T. Washington students
PROGRAM ASSISTANT: Miscellaneous program support (e.g., volunteer recruitment, webpage creation and maintenance)
11. Do you have reliable transportation from campus or your home to Booker T. Washington STEM Academy?
Yes
No
12. Do you speak a language other than English fluently? If so, please identify which language(s) you speak.
13. Do you have prior experience working with children? Please explain.
limited to
50
words.
14. List the name of a relative or friend that we can contact in case of an emergency.
15. Emergency contact's phone number
16. Emergency contact's relation to volunteer
Include your email address in your submission to:
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