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Volunteer Application

Please fill out the following application form.  Once we have received it we will contact you regarding the next scheduled Volunteer Orientation.

Personal Information * required fields

Name:

Address Line1:

Address Line2:

City:

State:

Zip Code:

Phone #:
E-Mail:
(if you do not already have an e-mail address, a free one is available to you at www.hotmail.com or www.yahoo.com)

Date of Birth:

Age:

Gender:

Male Female

School Name:

Graduation Year:

Emergency Contact Information

Name:

Phone Number:

Relationship:

General Information

How did you learn about the Patricia and Phillip Frost Museum of Science:

School
Website
Another Volunteer
Other

Another Volunteer: Please indicate volunteer's name

Other:

I have volunteer/work experience with individuals with disabilities:

Yes No

If so, when/where:

Please mark all that apply. I am:

A Student College
High School
Other (please explain)
Employed Full-time
Part-time
Where:
Retired Former Occupation:
A Community Service Volunteer Hours needed:

Reason:

Interests

Why are you interested in becoming part of our volunteer program:

If you are volunteering to fulfill your community service requirement, how many hours are you required to complete:

We require a minimum of 75 hours. Are you able to commit to complete the minimum:

Yes No

Please indicate which position(s) interest you most. If marking more than one position, please indicate your preference by rating them from 1 (most interested) to 10 (least interested):

Wildlife Center Aquatics Communication and Events
Collection Technician Exhibit Prototyper Environmental Citizen Scientist
Community Engagement Events Other: Please explain:

Availability

Please indicate the frequency that you anticipate being available to volunteer:

Occasionally
Monthly
Weekly
Daily
Seasonally (i.e. only in the summer, school holidays, etc.)
Long term (full-time for one full season or more)
Other: Please explain:

When would you like to start:

Are you available on weekdays: Yes No
Are you available on weekends: Yes No

Expectations

What do you hope to gain/experience by volunteering at the Patricia and Phillip Frost Museum of Science:

Please share any other pertinent information:

Reference
Please list one personal or professional reference

Name:

Phone:

Relation:

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