APEGBC Career Awareness Program
Volunteer Form

* Title:		Mr.     Mrs.     Ms.     Dr.
* First Name:
* Last Name:
System ID Number:
* Designation:		P.Eng.       P.Geo.       EIT       GIT       Engineering Student       Geoscience Student
Discipline of Practice/Study:

Contact Information
* Preferred Phone:
This is my:		home    /   business > contact
* Preferred Email:
This is my:		home    /   business contact
Employer:
Job Title

When do you prefer to volunteer?

Business hours Evenings Weekends

What Activities Interest You?

Job Shadowing Career Information Booth Events Science Fair Events (Judging) Classroom Presentations All Events

If you chose Classroom Presentations, what topics are of interest to you?

Chemical Flight Earth Machines/Energy Electricity Math Environment/Sustainability Structures/Building Career information

What grade levels do you prefer to work with?

Grades 3-6 Grades 7-9 Grades 10-12 All Grades

Additional Information

Please list any additional interests or hobbies:

Do you speak any languages other than English?

Yes No

If yes, please list:

If you have experience working with children/students, please describe it here:

Please repeat the Image Validation text

Thank you!