Science Club Mentor Application

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This application is for the Spring 2017 quarter (April - June 2017) of Science Club at one of the following four sites:

- Pedersen-McCormick Boys & Girls Club: 4835 N Sheridan Rd, Chicago, IL 60640
- TrueValue Boys & Girls Club: 2950 West 25th Street, Chicago, IL 60623
- NEW! Family Focus: 2010 Dewey Ave, Evanston, IL 60201

- NEW! MetaMedia at the YMCA: 1000 Grove St., Evanston, IL 60201

Science Club mentorship is open to STEM graduate students, staff, and postdoctoral fellows. We are not taking applications from undergraduate students at this time.

Instructions: Please fill out the form below. Note that the form must be filled out in one session and you cannot return to it at a later date. Once we receive your information, you will be contacted for a brief interview.

If you have any questions or concerns, please contact Ashley Jennings at ashley.jennings@northwestern.edu
5. Ethnicity (check all that apply)
6. Gender
7. Where do you work?
Are you primarily based on Northwestern's Evanston or Chicago campus?
8. What is your position?
Which year are you in graduate school?
9. What is your primary field of study?
Which graduate program are you enrolled in?
12. Where would you prefer to volunteer as a mentor?
13. For April - June 2017, please check the days of the week that you will be available after 3:30pm. *This question is required.