User Registration

Username*

Password*

Minimum Requirements: Between 7 and 15 characters.

Confirm Password*

Email Address*

Title*

First Name*

Last Name*

Suffix

Maiden Name

Work Phone and Extension (format: (123) 456-7890 x12345)

Please enter your Home Phone number. (Format: (123) 456-7890)

Home Phone (format: (123) 456-7890)

Please enter your Cell Phone number. (Format: (123) 456-7890)

Cell Phone (format: (123) 456-7890)

Languages Spoken*
English
French
Other

Please specify your other spoken language(s)

Languages Written*
English
French
Other

Please specify your other written language(s)

How did you hear about Let's Talk Science?

Do you wish to participate in Let’s Talk Science programs this year?*
Yes
No

Please choose an option under 'What best describes you?'

What best describes you?*
I am an educator (teacher or community leader) who would like to request a Let's Talk Science Outreach activity.
I am a student or faculty at a university of college and I want to join an existing Let's Talk Science Outreach site (student group at a university or college) for in-person and online volunteering.
I am a scientist, engineer or other professional and I would like the Let's Talk Science national office to find specific in-person and online volunteering opportunities that match my profile (instead of joining the student group at a university or college).
I am a student or professional and I am ONLY interested in online volunteering through ExploreCurioCity.org.
I used to volunteer with Let's Talk Science and I just want to stay in touch (I don't want to volunteer anymore)
I am a coordinator at Let's Talk Science Outreach site.