Fall 2022: SCFG Mentor Scientist Application

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Thank you for your interest in joining our team of talented, dedicated, and science-loving volunteers! Please fill out this application and tell us a little bit about yourself. Be assured that your information will not be shared with other organizations or in any way disclosed.

If the number of applicants exceeds the number of spaces available, priority placement will be given to mentors who are the most underrepresented in STEM (women of color, applicants from a low income background, applicants who are first generation college bound), as per the mission of Science Club for Girls.

Submission of this application DOES NOT guarantee admission.

All accepted mentors will be required to show proof of up-to-date vaccination against COVID-19 to volunteer with SCFG (both in person and virtually).

This semester we will offer both in person and virtual club options:

VIRTUAL:

Mondays 3:30pm - 5:30pm VIRTUAL

October 3, 17, 24, 31, November 7, 14, 21 and 28

Tuesdays 3:30pm - 5:30pm VIRTUAL

October 4, 11, 18, 25, November 1, 8, 15, 29

Thursdays 3:30pm - 5:30pm VIRTUAL

October 6, 13, 20, 27, November 3, 10, 17 and December 1

Saturdays 10:00am - 12:00pm VIRTUAL

October 8, 15, 22, 29, November 5, 19, December 3, 10

IN PERSON:

Tuesdays 2:30pm - 4:45pm KING OPEN SCHOOL, Cambridge

October 4, 11, 18, 25, November 1, 8, 15, 29

Wednesdays 2:30pm - 4:30pm EAST SOMERVILLE COMMUNITY SCHOOL, Somerville

September 28, October 5, 12, 19, 26, November 2, 9, 16, 30, December 7, 14

Thursdays 2:30pm - 4:30pm MOTHER CAROLINE ACADEMY, Dorchester

October 6, 13, 20, 27, November 3, 10, 17 and December 1

Fridays 2:30pm - 4:30pm AMIGOS SCHOOL, Cambridge

October 7, 14, 21, 28, November 4, 18, December 2 and 9

If you have any questions or would like more information, please feel free to contact us at any time at scfgprograms@scienceclubforgirls.org.

Personal Information

First Name

Preferred Name

Last Name

Email

Optional Secondary Email

Pronouns you use (Optional)

Date of Birth (MM/DD/YYYY)

Gender Identity (Select All That Apply)

Optional Gender Description (255 character max)

Mobile Phone Number

Preferred Contact Method

Address

Address 2

City

State

Zip Code

How did you hear about us?

Other Hear About SCFG

T-Shirt Size

Demographic Information

To keep Science Club for Girls' programs free, we get funding from many sources. Most ask for information about the background of our Mentors. Please help us keep Science Club for Girls FREE by filling out this information. This also helps make sure we reach a diverse group of Mentors.All information is confidential. We will never share specific information about you. We share this information for all mentors as a whole. For example: 40% of mentors are Latina; 50% are from low income families. Completing this is optional, meaning you don't have to do it. However, it helps Science Club for Girls continue to offer free programs.

What is your Race/Ethnicity?

Racial/Ethnic Background

Other Racial/Ethnic Background

Have you ever participated in a Free or Reduced Lunch program?

Lunch Program

Are you the first in your immediate family to go to college?

(A first-generation college student is defined as a student whose parent(s)/legal guardian(s) have NOT completed a bachelor's degree. This means that you are the first person in your family to attend a four-year college/university to attain a bachelor's degree.)

First Generation College Bound

Science Club Site Preferences

So you want to be a SCFG Mentor? This semester we will offer both in person and virtual programming. Below are the options on volunteering with our Kindergarten - 12th Grade Programs.

1st Choice

2nd Choice

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Your Affliation, Education and Interests

What is your primary institutional affiliation, university, or place of work?

Affiliation

Highest Level of Education

Highest Education

Other Education

What is/was your major, concentration or specialty?

Major, Concentration, Specialty

Other Major

Experience with Youth

Experience: The following section is dedicated to understanding your experience working with youth so that we can cater your volunteer training.

Have you ever volunteered with Science Club for Girls before? If "Yes" please indicate the program and year you volunteered in the Volunteer Detail box. Ex: King Open, Fall 2020

Past SCFG Volunteer?

Volunteer Detail

We'd like to know more about your experience working with young people. SCFG Mentors volunteer to mentor young girls and gender-expansive youth in grades Kindergarten through 8th grade, and our Junior Mentors, Grades 8-12.

Do you have any experience working with youth?

Please describe your experience working with youth (1,000 character max):

Reason for Joining Science Club for Girls

We want to gain a better understanding of our volunteers. Please tell us why you would like to volunteer with Science Club for Girls. What is your interest in this specific volunteer program? What do you hope to gain from this experience?

Reason for Joining (1,000 character max)

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Emergency Contact

Please provide Emergency Contact Information Below

Emergency Contact Name

Emergency Contact Phone

Relationship to Emergency Contact

Image Release

I hereby grant to Science Club for Girls, its successors, and assignees the rights to record and photograph the image and/or voice of my child on videotape and/or photograph, to edit such video or photo at its discretion, to incorporate the same materials as such as Science Club for Girls web page, video projects, and/or promotional or program materials in perpetuity. I authorize the use of such picture, film and videotape or any portion thereof for the purposes of promoting or training for Science Club for Girls. I understand that my child's full name will not be revealed. For a period of 90 days from the date of execution of this agreement, I may revoke the rights granted to Science Club for Girls herein. If revocation is not made within this time frame, all rights granted hereunder shall remain in full force and effect.

I hereby release you and anyone using said videotape, photos, or other material from any and all claims, damages, liabilities, costs, and expenses for which I now have or may hereafter have by reason of any use thereof.

I understand that the provisions of this release are legally binding.
Image Release

I also grant to Science Club for Girls the right to use my full name in conjunction with said image.

Mentor Training

Please make sure that you are able to attend VIRTUAL Volunteer Training on Saturday, September 24, 2022 9:00am - 12:00pm VIA ZOOM. At this event you will be trained in how to work with the curriculum you will be using, online classroom management, cultural competency, working with and mentoring your Junior Mentors and you will get to know the Program Managers. Mentor training is MANDATORY for NEW mentors and optional for returning mentors. If there are any questions or scheduling complications about attending training on this date please contact the Program Director scfgprograms@scienceclubforgirls.org

YES! I will attend
No, I cannot attend and will make arrangements with a program manager

Your Commitment to Science Club for Girls

I will do my best to ensure that I attend every session of the club I am assigned and attend all the check-ins with my Program Manager. I will let a SCFG person know if I need to miss a club or am running late. I understand that if I miss more than two clubs, I may be disqualified from volunteering with SCFG.

YES! I agree.

Submit

By clicking “Submit” below,

I certify that I have read, fully understand and accept all terms of the foregoing statement

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