Volunteer Application FormΔ MakeHERspace Inc. Volunteer Application FormThank you for your interest in volunteering with MakeHERspace Inc. Our mission is to empower girls and women through STEM education, entrepreneurship, leadership development, wellness initiatives, mentorship, and workforce readiness opportunities. Volunteers are essential to helping us create safe, innovative, and inclusive spaces where future leaders can thrive.SECTION 1: PERSONAL INFORMATIONPlease enter your personal details below.First NameLast NamePreferred NameDate of BirthAddressAddress Line 1Address Line 2CityStateZip CodeCountrySelect CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)RomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwePhone NumberEmail AddressPreferred Method of Contact Email Phone Text MessageSECTION 2: EMERGENCY CONTACTWho should we contact in case of an emergency?Emergency Contact NameRelationshipPhone NumberAlternate Phone NumberSECTION 3: VOLUNTEER INTERESTSPlease check all areas where you would like to volunteer:STEM Programs Coding & Programming Robotics Engineering 3D Printing Artificial Intelligence Maker Activities Science ExperimentsEducation & Mentoring Academic Tutoring STEM Mentorship Career Coaching College Readiness Entrepreneurship TrainingEvents & Community Outreach Event Support Workshop Facilitation Community Outreach Fundraising Events Conference SupportAdministrative Support Data Entry Office Support Research Grant Writing Program CoordinationMarketing & Communications Social Media Graphic Design Photography Videography Content Writing Website SupportProfessional Services Legal Services Accounting/Finance Human Resources IT Support Strategic PlanningOther SkillsSECTION 4: EDUCATION & EXPERIENCETell us about your background.Current OccupationEmployer/OrganizationHighest Education Completed- Select Education -High SchoolAssociate DegreeBachelor's DegreeMaster's DegreeDoctorateOtherRelevant Certifications or LicensesRelevant ExperienceSECTION 5: AVAILABILITYHelp us match you with the right opportunities.How often would you like to volunteer? One-Time Event Weekly Bi-Weekly Monthly As NeededPreferred Days Monday Tuesday Wednesday Thursday Friday Saturday SundayPreferred Times Morning Afternoon EveningEstimated Hours Available Per MonthHoursSECTION 6: BACKGROUND CHECK AUTHORIZATIONSome volunteer positions may require a background screening.Have you ever been convicted of a felony that has not been expunged or sealed? Yes NoIf yes, please explain:A criminal conviction does not automatically disqualify an applicant from volunteering. I authorize MakeHERspace Inc. to conduct a background check if required. Yes NoSECTION 7: REFERENCESPlease provide two professional or personal references.Reference #1Some description about this sectionNameRelationshipPhoneEmailReference #2Some description about this sectionNameRelationshipPhoneEmailSECTION 8: MEDIA RELEASESome description about this sectionI grant permission to MakeHERspace Inc. to photograph, video record, and use my image, voice, or likeness for educational, promotional, fundraising, and marketing purposes. Yes NoSECTION 9: VOLUNTEER AGREEMENTPlease read and confirm your agreement to the following policies.I understand and agree that: The information provided is accurate and complete. I agree to follow all MakeHERspace Inc. policies and procedures. I will maintain confidentiality regarding participants, families, and organizational information. I understand volunteering is unpaid unless otherwise specified in writing. I will conduct myself professionally and respectfully while representing MakeHERspace Inc.Volunteer SignatureDateParent/Guardian Signature (if under 18)Parent/Guardian Signature DateDate / TimeInterview Completed: Yes NoBackground Check Cleared Pending Not RequiredVolunteer Position Assigned:SupervisorStart DateApproved ByMakeHERspace Inc. Empowering Girls & Women Through STEM, Innovation, Leadership, and Entrepreneurship. ✨Submit Form
