BASIS Sign up – Impact100 East Bay, Inc.

BASIS Sign up – Impact100 East Bay, Inc.

Thanks for your interest in volunteering with Communty Resources for Science & Impact100 East Bay, Inc. for a science festival in October 2025.

Please fill in the registration form below. We need to have legal name and birthdate since you will be working with children under our name.

 

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First Name:
Last Name:
Legal Name: (If different from above)
Birthdate: (mm/dd/yyyy)
Email
Phone:
Race / Ethnicity: (collected for grant reporting purposes only) (select all that apply: hold down 'Ctrl' on a PC or 'Command/Apple' on a Mac)	American Indian or Alaska Native Asian Black or African American Native Hawaiian or Pacific Islander Hispanic / Latino White Mixed Race Other Prefer not to say
Many of the schools we serve have "language immersion" classes. Would you be comfortable communicating with students in any of the following languages (select all that apply: hold down 'Ctrl' on a PC or Command/Apple on a Mac)	Spanish Mandarin (Chinese) American Sign Language Cantonese (Chinese) French German Korean Japanese Tagalog Greek Arabic Italian

CRS Photo Policy: To document our work supporting science education for the community and funding agencies, CRS/BASIS at times take photos and/or videos of our programs in action. We do not include volunteer or student names when publishing these images online or in print. By participating as a BASIS volunteer, you consent to CRS use of your photo or video image, unless you expressly opt out in writing. If you do NOT consent to CRS use of photo/video of you, please send a message to teach@crscience.org