Chem Club New Member Application

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Interested in joining chemistry club? Fill out the contact form below, and we'll add you to the GroupMe so you can get announcements and information about our first meeting. At our first meeting, we'll go over more of what's in store for the club this year. :)

Email *

Last name: *

First name: *

Grade Level *

10th

11th

12th

Cell Phone Number (for GroupMe communication) *

Have you already taken chemistry? *

Yes! I have taken chemistry in an earlier semester. :)

I am taking chemistry now. :)

Other:

What makes you interested in joining chem club?

What would you specifically like to do as a part of the club this year?

Please read the safety contract at the link below.

https://drive.google.com/file/d/1xC8TDv4NNVubpITlG_Y-s0nbJhYYWw-P/view?usp=sharing

Then, you and a parent/guardian will need to type your name below. This constitutes your electronic signature stating that you have read and agree to abide by the safety rules presented in the contract.

Note: Most of the labs will be conducted virtually, so safety rules will apply differently. :)

Student Signature

Parent/Guardian Signature

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of MCBOE. Report Abuse

Forms