Gulfarium C.A.R.E Center Volunteer Application

PERSONAL INFORMATION
First Name*
Middle Initial
Last Name*
Date of Birth
Address 1*
Address 2
City
State*
Zip*
Phone*
Email*
Are you able to provide your own reliable transportation?*
Are you able to commit to a minimum of four shifts (4 hours each) per month for six months?*
Do you have any physical limitations?*
If yes, explain:
Are you a citizen of the United States?*
If no, are you authorized to work in the U.S.?
Have you ever worked for this company?*
If yes, when?
Have you been convicted of a felony?*
If yes, explain conviction
EDUCATION HISTORY
Highest Level of Education Completed*
School Name*
City*
State
Actual or Projected Graduation Date*
Field of Study*
ACADEMIC CREDIT
If selected, will you be receiving academic credit for your time?*
If receiving credit, fill out information below. *Please note we do not offer community service court-appointed opportunities.
Advisor/Superior's Name
Advisor/Superior's Mailing Address
City
State
Zip
Phone
Email
Fax
CERTIFICATION AND QUALIFICATIONS
What days of the week do you prefer to volunteer?*
What shifts do you prefer?*
Please select which areas interest you:*
Please list any relevant organizational affiliations:
Please list any special skills, training, or certifications:
PREVIOUS EMPLOYMENT OR VOLUNTEER EXPERIENCE
Company Name
Address
Phone Number
Supervisor Name
Job Title
Dates
From
To
Type of hire
Responsibilities
May we contact your previous supervisor for a reference?
Company Name 2
Address
Phone Number
Supervisor Name
Job Title
Dates
From
To
Type of hire
Responsibilities
May we contact your previous supervisor for a reference?
Company Name 3
Address
Phone Number
Job Title
Dates
From
To
Type of hire
Responsibilities
May we contact your previous supervisor for a reference?
GENERAL INFORMATION
What are your opinions regarding animals under human care?*
What do you hope to gain from this experience?*
What interests you the most about the Gulfarium C.A.R.E. Foundation?*
DISCLAIMER AND SIGNATURE
I certify that my answers are true and complete to the best of my knowledge. If this application leads to a position as a volunteer, I understand that false or misleading information in my application or interview may result in my release of duty as a vol
Name*
Date*