Please Print and Mail to:
Think Link
2609 N. Second St, La Grande OR 97850
Name: _____________________________________________________
Individual Volunteer . Group Leader . Both (Name of Group): _________________DOB:____/____/____
Address:____________________________________________________
City: _______________ State: _____________ Zip: ________________
Home Phone: _________________ Work Phone: ___________________
Other (specify): __________________________ E-mail: ____________
PERSONAL REFERENCES (students may use teachers and group leaders)
(1) Name and Relationship: ___________________________________
Address: ___________________________________________________
City: _____________________ State: ___________ Zip: ____________
Phone: ___________ Other (specify): ____________ E-mail: ________
(2) Name and Relationship: ___________________________________
Address: ___________________________________________________
City: ______________ State: __________ Zip: ____________________
Phone: _____________ Other (specify): ___________ E-mail: _________
EMERGENCY CONTACT
(1) Name: ______________________ Relationship: ________________
Phone: ___________________________ Other (specify): ___________
(2) Name: _____________________Relationship:__________________
Phone: ___________________ Other (specify): ____________________
REASON FOR VOLUNTEERING
Please check all that apply
Community service hours
Family/Friends are involved
Extra time
Personal fulfillment
Professional development
Service learning
Other__________________
How did you hear about Think Link Children’s Museum?__________________
What is the length of the commitment you wish to make? _____________________
How many hours per month/week do you wish to volunteer? __________________
Please note the Museum requires a minimum of service per month for certain positions. (see job descriptions.)
ASSIGNMENT INTEREST
Briefly explain why you want to volunteer at Think Link_____________
_____________________________________________________________
______________________________________________________________
______________________________________________________________
Please indicate your employment status. _ Employed full time _ Employed part time _ Retired _ Not employed
If employed:
Organization: ___________________ Supervisor: __________________
Address: ___________________________________________________
City:_________________________ State: _____________ Zip: _______
Phone: ______________ Other(specify):___________ E-mail: _________
Highest degree or level of school completed
_ High School/ GED _ Some college /Associate Degree _ Bachelor’s Degree _ Masters Degree
_ Professional Degree (i.e. MD, DDS, JD) _ Doctorate degree (i.e. PhD, EdD)
Are you currently a student? _ Yes _ No School__ Degree Program_________
Do you have past/other volunteer experience? General? _ Yes _ No With children? _ Yes _ No
Please list volunteer experience: ____________________________________________________________
Do you have any special needs or limitations in order to volunteer? ___ If yes, Please explain:______________________________________________________
Have you ever been arrested? ___ If yes, Please explain: _______________
_______________________________________________________________
Have you ever been involved in a criminal court case? ___ If yes, Please explain: _____________________________________________________
Have you ever been subject to a child abuse investigation? ___ If yes, Please explain: ______________________________________________
I understand and fully acknowledge that, in volunteering for Think Link Children’s Museum, I am entering an AT WILL relationship and that this relationship can be terminated at any time by me or Think Link Museum for good cause, bad cause, or no cause at all.
I further understand that by signing this agreement, I give permission to contact my references or to conduct a criminal background check if deemed appropriate. It is my understanding that all information I have provided is true and complete to the best of my knowledge. I understand that giving false information can be grounds for immediate dismissal.
I understand that I may come in contact with sensitive client information and that this information is confidential and is not to be repeated.
Volunteer Signature _____________________ Date _________________