Volunteer Application

Name: ___________________________________________ Date: _______________________

Address:_______________________________________________________________________

City: ______________________________________ State: _______ Zip: _________________

E-mail: ___________________________________ Month and day of birth:________________

Home Phone: ________________________ Alternate Phone: ________________________

Educational background:_________________________________________________________

Current Employer: ______________________________________________________________

Position:____________________________________  Phone: ___________________________

Past Employer: _________________________________________________________________

Position:_____________________________________ Phone: ___________________________

Hobbies, Skills, Interests:_________________________________________________________

Previous Volunteer Experience:____________________________________________________

Physician: _____________________________________________ Phone: _________________

Emergency contact: ______________________________ Relationship: ___________________

Emergency phone numbers:_______________________________________________________

Areas in which you are interested in volunteering:
  Teaching Education Programs
  Wildlife Assistant
  Grounds and Gardens
  Office Work
  Special Events (Festivals, Fund Raisers, Decorations)
  Visitors Center
  Other_____________________________________________________________________

Days and times available (if applicable)_____________________________________________

I certify that I am physically and mentally able to perform the volunteer assignments that I will accept. I hereby release any and all claims and demands that I may hereinafter have against the Chattanooga Nature Center, and any employee thereof for injuries to my person or damages to my property that may be suffered by me while performing volunteer services for the Chattanooga Nature Center.

Your signature: __________________________________________ Date: _________________