Black Girls Do STEM Volunteer Agreement

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By completing this form, I agree as a volunteer to abide by all applicable rules and regulations of Black Girls Do Stem. I agree to obtain a MO State Highway Patrol Name check background check, or my state of current residency, and to fulfill the volunteer responsibilities to the best of my abilities. I understand volunteers will not be able to serve without the required background check. I understand that I will not receive monetary benefit in return for the volunteer services, and that organization may at any time terminate this agreement without prior notice.

https://www.mshp.dps.missouri.gov/MSHPWeb/PatrolDivisions/CRID/crimRecChk.html
Click on Criminal Record Check Form, choose the $14 option.

Please submit background check via email to admin@bgdstem.com upon completion of this application. Make the submit of the email Your full name_ Background check.
Submit background check for your current state of residence for those outside of Missouri.

Volunteer Handbook: https://drive.google.com/file/d/1mOj2FvlShzKxA9oadSxkTeFUzyBtKdqZ/view?usp=sharing

Email *

Full Name *

Address *

Phone No *

Date of Birth *

YYYY

Drivers License No *

*If under the age of 18 will need to provide copy.

Emergency Contact (Name, Relationship, Phone No.) *

Volunteer role interested in, roles include: mentor, program site support staff, and work group member; Please list the appropriate work group. *

Mentor

Program Site Support

Work Group Member- Community Engagement and Outreach

Work Group Member- Volunteer Recruitment and Retention

Work Group Member- Special committee for fundraising (adhoc committee to the board)

Other:

I have read the volunteer handbook for Black Girls Do STEM and agree to the assigned roles and responsibilities and all other sections of the handbook as written, and I ascertain I can physically complete the tasks listed. *

*If you require special accommodations please note in other

Yes

Other:

Have you already attended the volunteer orientation? *

Yes

Full name and today's date (Electronic signature ) *

Are you a Saint Louis University Medical Student Volunteer?

Yes

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A copy of your responses will be emailed to the address you provided.

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