EqOpTech Volunteer Profile/Application Form
Email address *
EqOpTech, a 501(c)(3) nonprofit organization, promoting Equal Opportunity learning and STEM education through Technology in under-served communities
Your Name *
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Your E-mail *
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Your Contact Phone Number *
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Your mailing address *
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Your school affiliation *
Applying for the following unpaid position *
Interest areas
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Your work with EqOpTech may qualify as Public Service Hours for community service recognition programs. Check all that applies. *
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Average number of Hours you are willing to commit per week for this position *
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List your college plans and desired field of interest. How can EqOpTech help you accomplish those goals? (maximum 100 words) *
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Please help provide a short explanation why you would like to volunteer for the areas of interest you seek. (200 words maximum) *
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Please submit a short biography for the EqOpTech (maximum 75 words) website posting (N/A if you are under 14 years of age)
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Name of parent, if you are under 18 years of age *
Your answer
Cell Phone # of parent, if volunteer is under 18 years of age *
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E-mail of parent, if volunteer is under 18 years of age *
Your answer
If volunteer is under 18 years of age, EqOpTech requires that you submit a signed Parent Permission Form. Here's the link https://drive.google.com/file/d/0B7YV9UQgStghenM5WE9SdWhsaDA/view?usp=sharing Please e-mail the signed form to EqOpTech@gmail.com *
If volunteer is over 18 years of age, EqOpTech requires that you submit a signed Volunteer Liability Release Form. Here's the link, https://drive.google.com/file/d/0B7YV9UQgStghRmdONktFOFlmN1U/view?usp=sharing Please e-mail the signed form to EqOpTech@gmail.com. *
Allergies/Medical Information/Other, if any. *
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Emergency Contact # 1 - Name *
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Emergency Contact # 1 - Cell Phone *
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Emergency Contact # 1 - Relationship *
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Emergency Contact # 2 - Name *
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Emergency Contact # 2 - Cell Phone *
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Emergency Contact # 2 - Relationship *
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