Burpee Museum of Natural History · Volunteer Application

Date of Application

*

(mm/dd/yyyy)

Contact Information

Name

*

First Name

Last Name

Date of Birth

*

(mm/dd/yyyy)

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Email

*

Allergies/Medications

Emergency Contact Name and Phone Numer

*

Highest Level of Education

Elementary School

Middle School

High School

College/University

Graduate School

Additional Education/PhD

Volunteer Program Age Groups

*

Junior Volunteer (ages 8-13)

Volunteer Apprentice (ages 14-17)

Volunteer (ages 18+)

Internship (ages 18+ Stipend/Paid)

Areas of Interest (Check all that apply)

*

Collections

Biology Lab

Paleo Lab

Geology

Education

Special Events

Exhibits

Office Aide

Tours

Parental Waiver

*

I am over the age of 18

I am under the age of 18 and am required to have a legal guardian attend orientation with me

Criminal Waiver

*

I have no criminal history

I have criminal history and understand I may be subjected to a background check

Name

First Name

Last Name