Genius Lab volunteer/Intern Form

Mission Statement:

"Our mission at Genius Lab is to ignite curiosity, foster a love for learning, and empower the next generation of innovators. We are committed to providing a dynamic and inclusive environment where children, regardless of background or ability, can explore the exciting world of STEAM. Through hands-on activities, engaging programs, and mentorship, we aim to create an enriching educational experience for our community."

If you agree to our mission and are willing to be interviewed and trained in our procedures, we encourage you to complete this application. The information on this form will be kept confidential.

Name:

First Name

Last Name

Date of Birth

YYYY

Gender

Current School and Grade If Applicable

Email Address

Parent/Guardian Name:

First Name

Last Name

Parent/Guardian Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Any skills or talents you have that you feel would benefit the Genius Lab?

Emergency Contact Person

First Name

Last Name

Emergency Phone Number

(###)

###

####

Relationship to the Volunteer

How did you hear about us?

If its a friend please fill out their name

First Name

Last Name

Number of hours available to volunteer each week

Please list the time frame you are available to volunteer:

Monday: Start_________ End_____ Tuesday: Start_________ End_____ Wednesday: Start______ End_____ Thursday: Start________ End_____ Friday: Start___________End_____

By signing below, I confirm that the information provided on this form is accurate and complete to the best of my knowledge. I understand that this information will be used to ensure the safety and well-being of my child during their stay at Genius Lab.

Parent/Guardian Signature:

If you are between the ages 14 and 17 years old parents must fill out the below form. Please click on the Parental Consent Form button.

First Name

Last Name

Date

YYYY

Your Signature

First Name

Last Name

Date

YYYY

Parental Concent form

Valid NYS Working Papers