Name:

Address:

City:

State:

Zip:

Home Phone:

E-mail:

Ethnicity (optional):

Employer:

Your position:

Full-time or part-time?

City:

State:

Zip:

Phone:

E-mail:

Best way to contact you:

Please briefly describe your educational background.

Please briefly describe your background and your experiences in astronomy (if different).

Describe experiences you have working with schools or explaining astronomy to students and/or the public.

Please list any other experience you have working with children.

What grade level(s) do you prefer to work with (check all that apply)

Would you be interested in working with a community-based organization (e.g. Boys' and Girls' Club) or after-school program?

Why are you interested in working with Project ASTRO?

Please list astronomy organizations you are affiliated with and how long you have been involved.

How can any of the organizations mentioned above contribute to your participation in the project?
(e.g. Will your club put on a star party at your partner school?)

What topics or areas of astronomy are of particular interest to you?

We will make every effort to place you at a school that is convenient for you. Would you prefer to volunteer near to:

How far are you willing to travel?

How did you hear about Project ASTRO?

IMPORTANT: Some school districts require fingerprinting or a criminal background check for all non-parent volunteers. Are you willing to comply with your partner’s school policy for screening volunteers?

Is there any reason you would not pass a screen?

By checking the box, I certify that the above information is true and that I am able and willing to make the commitment of time and energy described above to Project ASTRO.