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inSTEM Role Model Volunteer Form
inSTEM Volunteer *	inSTEM Volunteer
First Name *
Last Name *
Title *
Company Name *
Email *
Phone Type *
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Phone Type 2
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Tell us about yourself.
Industry
Occupation
Years of Professional Experience
Undergraduate Degree
Master's Degree

Volunteer Preferences
Types of Volunteer Activity Perferred	Panelist Hands-on activity Role Model Speaker All of the above
Preference for Age of Kids	Elementary Middle School High School College All of the above
Day of the Week	Sunday Monday Tuesday Wednesday Thursday Friday Saturday Monday thru Friday Any day of the week
Time of Day	Morning Afternoon Evening All of the above

Location
Region	Southeast Michigan West Michigan All of the above
Travel Distance
Zip Code - Home
Zip Code - Work
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Inforum combines strategic connections, proven professional development programs, a respected forum for new ideas, and original research to accelerate careers for women and boost talent initiatives for companies.

Southeast Michigan
Phone: 313.567.0232

West Michigan
Phone: 616.588.9400

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