STEM Prep Volunteer Application
By submitting this form, you certify under penalty of perjury that the following statements are true and complete, and you authorize STEM Prep Schools, Inc., to complete a background check as a condition of school volunteer service, as provided by California Education Code 45125.5.
Email address *
First Name: *
Your answer
Last Name: *
Your answer
Maiden Name/Other Names Used: *
Your answer
Residence Address: *
Your answer
Cell Phone: *
Your answer
Work Phone: *
Your answer
Emergency Contact Name and Phone: *
Your answer
Date of Birth: *
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/
DD
/
YYYY
Length of residence in county? *
Your answer
Previous Address (if less than 5 years): *
Your answer
Physical Limitations: if yes, please explain. *
Relationship to any student(s) or staff member at school? If yes, please explain: *
Languages spoken: *
Required
Please respond to the following: I am interested in volunteering because *
Your answer
Do you have any felony convictions? If yes, please explain: *
Have you ever been convicted of any sex offense for which you must register with any Law Enforcement Agency pursuant to Penal Code 290? *
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