Mail completed form to our mailing address: Brillion Nature Center, PO Box 85, Brillion, WI 54110
Return completed form to our location: W1135 Deerview Road, Brillion
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 _____________________________