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LAST NAME: FIRST NAME:
HOME PHONE: CELL PHONE:
ADDRESS: CITY: STATE: ZIP:
EMPLOYER: JOB TITLE:
EDUCATION: CURRENTLY A STUDENT? YES NO IF YES, WHAT SCHOOL?
PREVIOUS VOLUNTEER EXPERIENCE (agency and position):
REASON FOR LEAVING:
IF YOU SPEAK A SECOND LANGUAGE FLUENTLY, PLEASE STATE (Please include sign-language):
Job Interest Areas (Please see job descriptions before completing)
Aquarist Volunteer Aquarium Interpreter Clerical Assistant Discovery Lab Assistant Exhibits Interpreter Kelp Tank Presenter Tide Pool Interpreter Visitor Service Volunteer Education Outreach
Skills
Aquarium Maintenance Art/Graphics Clerical Computers Crafts Desktop Publishing Photography Public Speaking Teaching Video
YOUR SPECIAL SKILLS (hobbies, training, interests)
WHY WOULD YOU LIKE TO VOLUNTEER AT BIRCH AQUARIUM? Volunteer shifts are available from 9am to 1pm, from 1pm to 5pm, seven days a week. Please let us know when you are available to volunteer.
Where did you learn about the Birch Aquarium at Scripps volunteer program?
If newspaper or website, please name:
TO BE COMPLETED BY ALL APPLICANTS
Have you ever been convicted of any criminal offense, fined, or placed on probation, or given a suspended sentence in any court other than a minor traffic violation for which the fine was $50.00 or less?
YES NO
EMERGENCY INFORMATION: Persons to notify in case of an emergency
NAME/RELATIONSHIP
HOME PHONE WORK PHONE
Do you have any allergies or sensitivities (bee stings, foods, drugs, etc.)? YES - Please explain. NO
Physical limitations that might restrict your activities? YES - Please explain. NO
REFERENCES
HOME PHONE
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