Wufoo

Name * First Last
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email *
Phone Number * ### - ### - ####
Birth Date * MM / DD / YYYY
Community Service/Class Credit Requirement: Are you volunteering for a class or community service credit? If so, Discovery Place, Inc. requires that you volunteer a minimum of 6 months before we can certify your service hours. *
No, I have a personal interest in becoming a volunteer Yes, as a volunteer, I agree to complete a minimum of 6 months of volunteer service.
Where are you interested in volunteering? *
Discovery Place Science Discovery Place Nature Discovery Place Kids-Huntersville Discovery Place Kids-Rockingham

Check all that apply.
Which position or positions are you interested in volunteering for? Choose up to three. *
Spontaneous Science Volunteer at any Museum Play Guide at Discovery Place Kids Groundskeeper Volunteer at Discovery Place Nature Butterfly Pavilion Docent at Discovery Place Nature Animal Husbandry at Discovery Place Nature Birthday Party Volunteer at Discovery Place Science Explore More Me Lab Assistant at Discovery Place Science Explore More Stuff Lab Assistant at Discovery Place Science Living Collections Assistant at Discovery Place Science School Group Ambassador at Discovery Place Science Science Engagement Interpreter at Discovery Place Science Welcome Ambassador at Discovery Place Science
Please list any hobbies or interests that you believe would be beneficial to volunteering at Discovery Place, Inc.
How many hours a week are you interesed in volunteering? *
I am generally available (Please select all that apply): *
Monday (AM) Monday (PM) Tuesday (AM) Tuesday (PM) Wednesday (AM) Wednesday (PM) Thursday (AM) Thursday (PM) Friday (AM) Friday (PM) Saturday (AM) Saturday (PM) Sunday (AM) Sunday (PM)
Interests & Experience
Areas of Interest at Discovery Place Science: *
Collections Live Exhibitions Live Shows & Floor Programs Explore More labs Early Childhood Summer Camps (June-August only)

Check all that apply.
Areas of Interest at Discovery Place Nature: *
Animal Husbandry School Classes Museum Floor Office Assistant Outdoor Maintenance/Gardening Summer Camps (June-August only)

Check all that apply.
Areas of Interest at Discovery Place Kids: *
School Classes Museum Floor Birthday Parties (Saturday & Sunday) Summer Camps (June-August only)

Check all that apply.
Summarize any specials skills or qualifications you have acquired from employment, previous volunteer work or other activities, including hobbies or sports. Please also list any foreign language skills. *
Summarize any previous volunteer experience. *
How did you learn about Discovery Place volunteer opportunities? *
From a Museum employee From a Museum volunteer Through Volunteer Match discoveryplace.org Other
Name of Employer *
Does your employer provide grants or matching funds in recognition of volunteer service hours? *
Yes No
Please indicate the name of any Discovery Place volunteer or employees with whom you are acquainted. If not applicable, please write none. *
Emergency Contact
Name * First Last
Home/Cell Phone * ### - ### - ####
Work Phone * ### - ### - ####
Email *
AGREEMENT AND CERTIFICATION:

As a volunteer I agree to hold confidential all privileged, and or sensitive information which I may obtain directly or indirectly concerning Discovery Place, Inc. Confidential information does not include any information that is now or in the future publicly known or information that becomes available to you through a third party. I agree that my services are donated to Discovery Place, Inc. without contemplation or compensation, or future employment. I agree to grant permission without compensation to Discovery Place, Inc. to use my name, voice, statements, photographs, and other reproductions and likenesses for promotional purposes (e.g. press releases, audio visual and printed materials). I agree to comply with the policies and procedures set forth by Discovery Place, Inc. as it pertains to working with minors which may be found in the Volunteer Portal.

Initial: *
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Wufoo

Interests & Experience

Emergency Contact