This application is for a volunteer opportunity at the FLINT HILLS DISCOVERY CENTER. The Flint Hills Discovery Center is managed by the City of Manhattan. To apply, please complete this application form then click the green continue button at the bottom to submit the application.

Name and Address

First name:

Last name:

Nickname:

Street 1:

Street 2:

City:

State:

* Zip: *

Primary Contact Number

This can be a cell phone, home phone, or work phone.

Home phone:

OK to call me here

Work phone:

OK to call me here

Cell phone:

OK to call me here

Email address:

Demographic Information

Date of birth:

* (year optional)

Gender:

Detailed Self-identified Ethnicity:

Availability

Please indicate the days and times you would be available to volunteer.

Volunteer Opportunities

Please indicate which opportunities you are most interested.

Education and Work Experience

Please list your relevant education, work and volunteer experience.

Education:

School:

1

2

Employer name:

City:

State:

3

Employer name:

City:

State:

References

Please list two references who are not related to you.

1

2

First name:

Last name:

Street 1:

Street 2:

City:

State:

Zip:

Email address:

Relationship:

Emergency Contact

Please list someone we would contact on your behalf in an emergency.

First name:

Last name:

Home phone:

OK to call here

Work phone:

OK to call here

Cell phone:

OK to call here

Email address:

Relationship:

Authorization and Release

I certify to the best of my knowledge, all information given by me in this application is true and correct. I authorize the Flint Hills Discovery Center to utilize this information to determine my volunteer placement. I understand that I will be expected to abide by the Flint Hills Discovery Center policies and procedures, which will be provided to me as part of my orientation process.

I Agree