Volunteer Registration Form

First Name: *

Last Name: *

Home Address

Home Address Line 1: *

Home Address Line 2:

City: *

State: *

Zip Code: *

Work Address

Employer: *

if student, enter school name

Position: *

if student, enter "student"

Work Address Line 1: *

Work Address Line 2:

City: *

State: *

Zip Code: *

Phone and Email

Cell Phone:

Work Phone:

Email: *

Home Phone: *

How did you hear about Steps to Success or the African American Male Initiative:

How are you interested in volunteering: *

Guest Speaker at Saturday Academy (once for 1.5 hours)

Escort Boys on Saturday Outings (4 hrs/trip)

Host group of boys at your office

Fundraising/ Sponsorships

Event Planning/ Promotion

Academic Assistance

Volunteer Recruitment

Website Development

Other ideas

Guest Speaker

Please fill out this section if you are interested in being a guest speaker at our Saturday Cultural Academy.

Availability:

Contact me once opportunities become available

Brief Biography:

If you selected to be a guest speaker, please upload a brief biography.

Information for Research Purposes (optional but helpful?)

How do you describe yourself ethnically:

Age:

Highest Education Completed:

Income:

Universities Attended

College:

Masters:

PhD:

Law School:

Other Professional Degree:

The African American Male Initiative

The Children's Aid Society