Adult Volunteer Application

Please complete this application form if you are interested in becoming a MDWFP's Mississippi Museum of Natural Science volunteer. Once you complete the form, click the Continue button at the bottom. For questions or help, Contact TJ Tippit, thomas.tippit@mmns.ms.gov

Name and address

First name:

Last name:

Title:

Nickname:

Street 1:

Street 2:

Street 3:

City:

State:

* Zip: *

Home phone:

* OK to call me here

Work phone:

* OK to call me here

Cell phone:

* OK to call me here

Email address:

Why are you interested in volunteering at the Mississippi Museum of Natural Science?

Educational Background

Education:

School:

How long did you attend? Did you receive a degree?

Professional Background

Employer name:

Street 1:

City:

State:

Zip:

Work phone:

OK to call here

Email address:

Current occupation and employer, if retired, former occupation(s)

Previous Volunteer Experience

Please list previous volunteer experience

Interest Inventory

Is there a particular type of volunteer work that interests you? Some examples are: exhibit hall docent, garden docent, aquarium docent, collections docent, trails/grounds docent, preschool docent, aquarium diver, events docent

Availability

Please indicate the days and times you are usually available to volunteer.

Sun

Mon

Tue

Wed

Thu

Fri

Sat

From:

To:

My availability is:

From:

to:

I would like to serve up to:

hours:

Demographic Information

You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.

Date of birth:

Gender:

Email Preferences

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.

What kinds of email would you like to receive?

Electronic newsletters

Recruitment appeals

References

Please provide references, other than family members

1

2

Employer name:

First name:

Last name:

Home phone:

* OK to call here

Home phone:

* OK to call here

Work phone:

OK to call here

Work phone:

OK to call here

Cell phone:

OK to call here

Cell phone:

OK to call here

Email address:

Relationship:

Contacted:

Verified:

3

Employer name:

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:

Contacted:

Verified:

Emergency Contacts/Medical Information

Please provide two emergency contacts

1

2

First name:

Last name:

Street 1:

City:

State:

Zip:

Home phone:

* OK to call here

Home phone:

* OK to call here

Work phone:

OK to call here

Work phone:

OK to call here

Cell phone:

* OK to call here

Cell phone:

* OK to call here

Email address:

Relationship:

Please note any medical conditions of which we or emergency personnel should be aware. This information is only used in the event you require assistance.

How did you hear?

How did you hear about volunteering at Mississippi Museum of Natural Science?

Background

Have you ever been convicted of a crime? If yes, please explain

MMNS Adult Volunteer Contract

The agreement between Mississippi Museum of Natural Science (MMNS) and the adult volunteer,

_______________________________ , is as follows.

THE ADULT VOLUNTEER AGREES TO THE FOLLOWING:

1. To abide by all policies and procedures of MMNS, as outlined in the volunteer handbook.

2. To provide accurate and up-to-date information on all application materials.

3. To successfully complete volunteer orientation prior to service.

4. To schedule volunteer service in advance by agreement with the volunteer coordinator, through phone call, e-mail, or by signing up on the calendar in the volunteer office.

5. To arrive on time as scheduled, willing to carry out assignments and duties with a positive attitude and in a responsible manner.

6. To provide a minimum of 24 hours notice if unable to work, except in the case of emergency or sudden

illness.

7. To successfully complete all required training for his/her particular position.

8. To commit to providing volunteer service on a regular basis.

9. To sign in and sign out accurately each time volunteer service is provided.

10. To accept MMNS’s right to dismiss any volunteer for poor performance, including attendance, conduct or attitude.

THE MISSISSIPPI MUSEUM OF NATURAL SCIENCE AGREES TO THE FOLLOWING:

1. To provide a professionally structured and well-managed volunteer program.

2. To provide orientation, on-the-job training, evaluation, and supervision for the volunteer.

3. To provide accurate record keeping of service and recognition for that service.

4. To provide enrichment opportunities for volunteers in addition to regular training.

6. To allow for change of assignments as appropriate for both MMNS and the volunteer.

7. To provide each volunteer with a nametag and a copy of the volunteer handbook.

8. To provide responsible volunteers with a reference, if needed, for future employment or education.

_________________________________________ ___________

Adult Volunteer Date

_________________________________________ ___________

Volunteer Coordinator Date

I Agree