Youth CAUSE Intern Form

Youth CAUSE Initiative Intern and Volunteer Planning Form

Please complete the online "Youth CAUSE Initiative form" below. NO PAPER COPIES WILL BE ACCEPTED. For questions please contact Dr. Rob at rob@youngscientistacademy.org.

Participant Details

* Indicates required field

Youth CAUSE Initiative Participant Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Date of Birth *

I identify my gender as: *

Participant Phone Number *

What school will you attend in Fall 2021? *

What grade will you be in Fall 2021? *

I accept my participation in the Youth CAUSE Initiative as a/an: *

Voyage Youth Employment Program Participant Volunteer

Parent/Legal Guardian Details

Please complete this section if participant is 18 years of age or younger.

Parent/Legal Guardian Name #1 *

First

Last

Parent/Legal Guardian Name #2 (Optional) *

First

Last

Best Parent Phone Number *

Parent Email #1 *

Parent Email #2 *

Schedules & Personal Expectations

I am available to work the following shifts on Tues-Fri: *

Morning - 8a-12.30p Afternoon - 12p-4p Evening - 3p-7p

Can you work Saturday shifts? *

Yes No

Please list any people you would like to work with each shift? *

What are your goals for the summer? What things would you like to learn? *

Which of the following field adventures would you like to attend? *

NC Museum of Art & NC State Tour (possibly Epic Games) Lake Waccamaw Weather Balloon Launch Fort Fisher & Carolina Beach State Park Bald Head Island Conservancy Sea Turtle Trip None

Skills and Attributes

Have you taken any science classes at school? *

Yes No

If yes, what science topics? *

Which of the following science themes are you familiar with? *

Climate Change Urban Sustainability Public Health

Which research projects would you like to be a part of this summer (can select as many as you like): *

Mission Sol Weather Balloon Climate project Jellyfish Climate Experiments Cape Fear Heat Map Project Wilmington Greenspace & Storm Drain Flooding Project Python Coding & Website Development Marketing and Branding Vaccination Strategies & Public Health Issues for NHC Food deserts & Nutrition Water Quality & GenX Monitoring

Are you currently CPR certified? *

Yes Previously certified but it has expired No but I would like to be certified

Do you speak any Spanish? *

Yes No

What skills do you have that you could employ this summer? *

Do you have any favorite food items or recipes? *

What social media platforms do you use? *