Science, Engineering and Mathematics Link, In.
P.O. Box 93641 •Atlanta, GA 30377• Phone/ Fax: 678-496-5060
Email: info@semsuccess.org • Website:
www.semsuccess.org
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Volunteer Information Sheet
20090726-1847
Volunteer Name
First Name:
Middle Initial:
Last Name:
Contact Information
Address:
City:
State:
Zip:
Phone Number:
Email Address:
Best method of contact:
Phone
Email
Title:
Organization:
Degree or Major:
Area of interest
AdministrativeVolunteer
Career Exploration Activity Leader
Math and Science Fair Judge
Math and Science Fair Project Mentor
Science Cafe Discussion Leader
Workshop Facilitator
Please indicate preferred age group
Elementary School
Middle School
High School
Please indicate your availability
- Check the time of day and use the detail space to write in specific times of availability:
During school day
After school
Evenings and weekends
Detail:
Please list the name and contact information for two personal and/or professional references that you have known for at least one year. Indicate how long you have known them:
Name:
Contact Phone:
How long have you known this refernce:
Name:
Contact Phone:
How long have you known this refernce: