Become an EIR

Thank you for your interest in the Engineer-in-Residence program.

By completing this application, you are registering to become an Engineer-in-Residence, a PenPal Engineer or a member of our Brainstorm Crew. The information you provide will be used by the EIR Program Office to ensure the best possible match with a school, and will not be shared with third parties without your permission. You may also register online at www.eir.ca.

Orientation Session:
Volunteer engineers and their teacher/partners are asked to attend to attend a 1-day orientation session in late September or early October. You will receive more information about this once you have been matched with a school. Members of the Brainstorm Crew do not have to attend this orientation, but will be asked to participate in a 1-hour teleconference.
Volunteer Reference Check:
The EIR program requires that all volunteers working with children undergo a basic police check. Please do this as soon as possible. Reference checks are conducted by your local municipal police force. In some jurisdictions, all police stations provide the service, while in others it is available only in the large ones. A phone call to any station or the community relations office will give you the locations. You must go in person, and you will need two pieces of identification. Sometimes you may need a letter of reference from either us or the school - every police precinct has its own policies. Again, the best thing to do is call any local station to ask about their procedures.


1. I am applying to become a(n):
 
Engineer-in-Residence
PenPal Engineer
Brainstorm Crew Member
 
2. Contact Information:
 
Your Name
Professional designation
License Number in Ontario
Preferred Email Address:
 
Company Information (if applicable)
   Company name
   Position
   Complete address/postal code
   Telephone number
   Fax number
 
Home Information
   Address/postal code
   Telephone number
 
Which location would you prefer the EIR program office use?
    Company information
    Home information
 
Professional Information
 
3. Please list your college and university degrees with area of specialty and dates received.
 
4. In total, how many years of engineering experience do you have?
    Less than 1 year 6 years-10 years
    1 year-3 years 11 years-15 years
    4 years-5 years 16 years or more
 
5. Are you currently...
    Employed - full-time On maternity leave
    Employed - part-time Homemaker/full-time parent
    Self-employed Seeking employment
    Retired Other (please specify):
 
6. Are you fluent in any languages other than English? If yes, please list:
   
 
Location and Availability
(For those applying to Brainstorm Crew, please skip to question 14)
 
7. Please list the community/district (in order of preference) for your assigned school. (Please specify up to 3 locations)
Note: PenPal Engineers may be assigned to schools that are further away due to the nature of the program.
     1.
     2.
     3.
 
8. How many hours a week in total (prep time, onsite, etc.) are you willing to spend?
(Please specify number of hours below)
   Number of hours
 
9. Have you already received permission from your employer to participate in this program?
      Yes (please go to Q. 12)
      No (please go to Q. 10)
      Not applicable (please go to Q. 12)
 
10. Do you require assistance from the EIR Program to obtain permission to participate in this program?
      Yes (please go to Q. 11)
      No (please go to Q. 12)
 
11. If necessary, whom would you like us to contact? (Please provide information below)
   Name:
   Position:
   Telephone:
 
Experience Working with Young People
 
12. Have you had any recent experiences working with young people
(e.g., children's clubs, guides, scouts, coaching, etc.)?
      Yes
      No
   If yes, please give a few examples
 
13. Have you had any formal experience giving presentations/teaching to children and/or teenagers?

  Giving Presentations to... Teaching...
Children
Teenagers

   If yes, please give a few examples
 
14. Do you prefer to work at a(n):
    Elementary School (grades K-8)
    High School (grades 9-12)
    Does not matter
 
EIR Program Information
 
15. How did you hear about the EIR program?
From another EIR Conference/Convention
Internet Mailing
Professional Engineers Ontario (PEO) Other (please specify)
 
16. Why do you want to be involved in the EIR program?
 
17. The EIR program requires that all volunteers working with children undergo a basic police check. Do you have any objections to this?
    Yes
    No
 
 
18. Please email a photo of yourself (.jpg) to rebecca@impactg.com for use on our website.
 
19. What type(s) of engineering do you practice (civil, aerospace, mechanical etc.)?
  
20. Please provide us with a short bio (50-200 words) about yourself for the website. The bio should allow people looking for answers to questions know a little bit about your background as an engineer and any areas of expertise you might have.
  
        Name/Signature:
        Date: