Please complete this application if you are interested in becoming a Volunteer Diver with the North Carolina Aquarium at Pine Knoll Shores. Once you complete the form, click the submit button at the bottom.

Name and address

First name:

Last name:

Middle name:

Nickname:

Street 1:

Street 2:

City:

State:

* Zip: *

Home phone:

Cell phone:

Email address:

Date of birth:

Age:

Pronouns:

Spouse's name:

Emergency Contact

First name:

Last name:

Home phone:

Relationship:

Education

Education:

Major degree:

Minor degree:

Please list any other training or certifications you have received and your degree/diploma (if applicable).

Work Experience

1

2

Employer name:

City:

State:

Please note your occupation (if retired, give most recent paid employment). If you are a student list the institution you are currently attending.

Diver Certification and Experience

Please note the highest level of recreational certification, certifying agency, the date of certification, number of logged dives, and date of last dive.

First Aid/CPR

If you have your First Aid, CPR or other related certification, please note the type and expiration date of the certification.

Volunteer Availability

Please list all the days of the week you are available to volunteer and the days of the week that you prefer to volunteer.

Volunteer Experience

Please note the organizations and dates of volunteering and your responsibilities.

References

1

2

First name:

Last name:

City:

State:

Zip:

Home phone:

Cell phone:

Important Note

You must pass a NC Aquarium dive physical and swim test before participating in this program. The required commitment for this program is one full day (9 a.m. - 4 p.m.) every two weeks, for a minimum of one year.

Have you ever been convicted of an offense against the law other than a minor traffic violation? Yes or no. If yes, please explain. (Conviction does not necessarily preclude an applicant from volunteer positions.)

Acknowledgment

I certify that the statements made in this volunteer application are true and correct, and I have not knowingly withheld any information. If the information provided in this document is found to be untruthful, I understand that I will be released from the volunteer program. I authorize verification of all information contained in the application and grant permission for references to be contacted.

I understand that I will not be paid for my services as a volunteer, and that filling out an application for the program does not guarantee acceptance into a volunteer position.

I understand that as a volunteer at the North Carolina Aquarium at Pine Knoll Shores, I will be expected to demonstrate a serious commitment to uphold the mission of the Aquarium, to maintain an environment of integrity for people and the animals, and to focus on customer service, with respect for all employees, volunteers and guests. I agree to follow Aquarium guidelines and policies.

I Agree