VolunTeen Application

Mail completed form to our mailing address:   Brillion Nature Center, 315 S. Main Street, Brillion, WI  54110
Return completed form to our location:   W1135 Deerview Road, Brillion
Name _________________________________________________________________

Address ________________________________________________________________

City __________________________________ State ________ Zip ________________

Phone Number _____(_______)_________________________

E-mail address ___________________________________________________________


                In case of an emergency, contact:

                Name __________________________________relationship ________________

                Phone Number _____________________________________________________

                Alternate Phone Number _____________________________________________


Age/Last grade completed:


Preferred days and times you are available to volunteer (Circle all that apply):


           Tuesdays   1:00 p.m. - 3:00 p.m.      or     Wednesdays    9:00 a.m. - 11:00 a.m.


How did you learn about Brillion Nature Center’s volunteer opportunities?


Employment Experience if any:


Volunteer Experience if any:


Why do you wish to volunteer with Brillion Nature Center?  What skills would you like to develop through volunteer service?


Please list your interests/hobbies.


All statements made on this application are true, complete and correct to the best of my knowledge and belief.


Signature ______________________________________________Date _____________


Parent or guardian signature if applicant is under 18 _____________________________