National Mississippi River Museum & Aquarium

(Please fill out form completely. Volunteers must be 14 years of age or older)

Personal Information

Name:

Gender

Male Female

Parent/Guardian's Name:
(if you are under 18)

Street:

City:

State:

Zip:

Phone (with area code):

(evening)

(daytime)

School or Employer:

Email:

Business/School Address:
If retired, please indicate and list former employer)

School grade level or Position at work:

How did you hear about volunteer opportunities at NMRMA?

	Brochure		Workplace Notice
	Friend or Family		Internet (which site?):
	Newspaper (which?):		Other:

Education and Experience

	Degree	Subject	Institution Name	Date Completed or Anticipated Date
High School
College/University
Graduate School
Trade, Business, or other school
Specialty Training

Do you speak any languages besides English fluently?

No Yes:

Do you have previous volunteer experience?

No Yes

If yes, please briefly describe this experience. Include the type and dates
of the experience and name of the organization.

References

Please list two work, school, or personal references, not relatives, whom we may contact regarding your application.

Reference 1		Reference 2
Name:		Name:
Daytime phone w/ area code:		Daytime phone w/ area code:
Street:		Street:
City:		City:
State:	Zip:	State:	Zip:

Interests and Work Schedule

I am interested in the following areas:
	Educator/Exhibit Hall Interpreter	Archives
	Greeter	Gift Shop
	Mailings	Special Events
	Other:

Special Interests:
	Animals	Riverboats
	Drama	Promotion
	Natural Resources	History
	Other:

When are you able to volunteer? Weekdays Weekends

What hours would you be available to volunteer? List the hours of the day below the days you are available.

Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday

VOLUNTEER INTERVIEWS AND TRAINING
All potential volunteers must apply in writing, and will be interviewed prior to being accepted. Those who would like to work as educators must complete up to 15 hours of formal training. Other positions require on the job training. Please call the volunteer office at 563.690.0933 for additional information or to arrange an interview.

CRIMINAL BACKGROUND CHECK (Adult volunteers only)
Following the interview, the National Mississippi River Museum & Aquarium will request the Iowa Bureau of Criminal Apprehension to release all information and data authorized under the Iowa law, for the purpose of your volunteering at the Museum & Aquarium. A signed consent form is required before this check can be completed. Convictions and pleas are not an automatic bar to volunteering. Relevant factors such as the nature of the
violation, how recent and serious the charges, as well as evidence of rehabilitation will be considered.

Volunteers, Parents, & Guardians, please read and sign below:

I hereby affirm that the information provided on this application is true and complete to the best of my knowledge. I authorize persons, schools, my current employer (if applicable), and previous employers and organizations named in this application to provide any relevant information that may be required. I also agree that falsified information or significant omissions may disqualify me from further consideration and may be considered justification for dismissal if discovered at a later date.

I understand that I will be interviewed prior to being accepted as a museum volunteer and I/applicant will be expected to complete the required training for museum volunteers. I understand that youth volunteers must be at least 14 years of age to be accepted.

By checking this box you are agreeing to the above statement

Applicant's name: Date: (00/00/0000)

Applicant is under 18. He/She has my permission to become a volunteer at the Mississippi River Museum.

Parent/Guardian's name: Date: (00/00/0000)