Adult Volunteer Appliction 2021

Adult Volunteer Application

Thank you for your interest in becoming an SSC Volunteer! Please allow 2-3 weeks for your confidential application to be reviewed and to be contacted to schedule an interview.

If you have any questions, please contact Laura Bahl, Volunteer Coordinator, at l.bahl@sscnh.org.

Please note: all applicants age 18 and over are required to fill out a Criminal Record Release Authorization Form; participation in this program is contingent on the report.

Youths ages 13-17, please fill out the Youth Volunteer Application form.

______________________________

Today's date:

First name: *

Last name: *

Address *

Address 2

City *

State/Province *

Zip *

Primary Phone: *

Alternative Phone:

Email *

Please check the area(s) you are interested in serving:

Environmental Educator

Exhibit Interpreter

Special Events

Special Projects

______________________________

Please indicate why you would like to volunteer (include any special interests):

Please indicate any allergies/medical conditions that we should be aware of:

Do you have any special needs that we should be aware of?

Yes

No

If you have a coach/aide, please provide their name, phone number, and agency they are with:

______________________________

Current/Past Employment:

Employer:

Position:

______________________________

References (non-relatives):

#1 Name:

#1 Relationship:

#1 Phone:

#2. Name:

#2 Relationship:

#2 Phone:

______________________________

Emergency Contacts:

#1 Contact Name: *

#1 Contact Relationship:

#1 Contact Phone: *

#2. Contact Name:

#2 Contact Relationship:

#2 Contact Phone:

______________________________

If you do join as a volunteer, you will be asked to fill out the V olunteer Waiver and Liability Form and bring it to the Center on or before your first shift.

Authorization to Obtain Information:

I. the undersigned, authorize any agent of the Seacoast Science Center, to obtain information regarding my employment, volunteer experience, or personal reference in connection with my application for volunteer service. Such information will be held in confidence in accordance with agency guidelines:

Required *

I agree

I do not agree

It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.