Volunteer Application

Name (Mrs. Ms. Mr.)_____________________________________________________

Address ________________________________________________________________

City __________________________________ State ________ Zip ________________

Phone Number _____(_______)_________________________

E-mail address ___________________________________________________________

 

            In case of an emergency, contact:

            Name __________________________________relationship ________________

            Phone Number _____________________________________________________

            Alternate Phone Number _____________________________________________

 

How much time would you be willing to volunteer?

 

 

Preferred days and times you are available to volunteer

 

 

Education, Training, Skills

 

 

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

 

 

Employment Experience if any

 

1.  Employer ____________________________ Dates _________________________

 

     Position ____________________________

 

2.  Employer ____________________________ Dates _________________________

 

     Position ____________________________

 

Volunteer Experience if any - Optional

 

1.  Agency name __________________________Address___________________

 

     Position______________________________ Dates _____________________

 

2.  Agency name __________________________Address___________________

 

     Position______________________________ Dates _____________________

 

 

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.

 

 

 

Is there a specific need at Brillion Nature Center for which you would like to volunteer or that you would like more information about?  (Building Monitor, Trail Patrol, Naturalist Assistant, Special Events, any other area)

 

 

 

Have you ever been convicted for a violation(s) of the law (other than minor traffic violations)?   Yes ______ No ______  If yes, please explain on separate sheet of paper.

 

For Program Volunteers only:  Please fill out and sign the attached Disclosure Statement for the required background check

 

References:  Please list the names, complete mailing addresses and phone numbers of two people we may contact.  References may be friends, neighbors or people who are familiar with your employment, volunteer or educational experiences.

 

 

 

 

All statements made on this application are true, complete and correct to the best of my knowledge and belief.  You have my permission to verify this information and contact references.

 

I grant permission for Brillion Nature Center to take photographs and videotapes of me during volunteer activities and for their use in Brillion Nature Center promotions and presentations.

 

New volunteers must complete an application form, have a one on one interview/

orientation with the Naturalist before being considered an active Brillion Nature Center volunteer.

 

Signature ______________________________________________Date _____________

 

Parent or guardian signature if applicant is under 18 _____________________________

 

 

 

 

 

Name:

 

How would you prefer to be contacted regarding volunteer opportunities:

 

o          Phone:

o          Email:

 

Volunteer Opportunities:  Please check activities of interest:

 

Restore and preserve the land

o          Remove invasive plants

o          Pick up trash

o          Monitor bluebird trail

o          Biological control of purple loosestrife (raising beetles)

 

Event Planning Committees

o          Spring Banquet

o          Other Fundraising Events

 

Environmental Education

o          Lead programs

o          Assist with programs

o          Create teaching aids

 

One-time projects/events

o          Split firewood

o          Maple syruping

o          Landscaping projects

o          Carpentry projects

o          Construct displays

 

Office and clerical work

o          Create brochures/flyers

o          Open and staff building

o          Office clerical (assist with mailings)

 

Buildings and Grounds

o          Monitor a Trail

o          General cleaning

o          Gardening

o          Pond maintenance

o          Animal feeding/maintenance