VolunTeen Application

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

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 _____________________________