Scientists & Innovators in the Schools Volunteer Application

To be considered for the program, please fill out this form with as much detail as possible


(*) indicates required fields

Title
Dr.Ms.Mrs.Mr.
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Name (*)

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Email Address (*)

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I prefer to receive SIS correspondence via email
yesno
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Occupation

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I am
a studenta working professionalretired
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Employer/School

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Business/School Address

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City

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Postal Code

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Business Phone

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Fax

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Home Address

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City

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Postal Code

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Home Phone

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Please send mail to
Business/SchoolHome
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Degree or certification obtained (eg. BSc Physics)

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Year

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Program

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YOU MUST FILL IN THE FOLLOWING INFORMATION
(NOTE: 90% of requests are for grades 1–5 classes)

I prefer to present to the following grades (*)
K-34-78-910-12any/all
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Total number of visits I can make during the year (*)

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No. of these visits I can make within my city

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No. of these visits I can make within Lower Mainland (between West Vancouver & Maple Ridge)

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No. of these visits I can make over 100km (generally requires overnight stay)

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I can talk to school children about the following topics
Animals
Biotechnology
Building Design
Careers in Science
Chemistry
Computers
Earth & Environment
Electronics
Engineering
Health Sciences
Mathematics
Oceans
Physics
Plants
Space
Technology
Women in Science
Other

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Details (e.g. Engineering-Civil, how to build bridges).

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I can present in French
YesNo
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When are you available to start visiting classes?

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Would you like to attend a training workshop?
YesNo
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I have previously volunteered for this program
Yes (specify year)No
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Year

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How did you hear about our program?

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Please indicate if you would be interested in volunteering in the following areas
Science Fair Judging
Career Days
Responding to student questions via email
Science Festivals in communities across BC

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Briefly describe any previous experience you have working with children and why you would like to volunteer for this program

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Please enter the letters/numbers as you see them


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