Mail completed form to our mailing address:   Brillion Nature Center, 315 S. Main Street, Brillion, WI  54110

or

Return completed form to our location:   W1135 Deerview Road, Brillion

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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 _____________