Volunteer Application Tell us about yourselfName* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell Phone*Email* Are you over 18 years old?* Yes No Will you be volunteering to fulfill a class requirement for the University of Tampa Psychology Department?* Yes No Are you 14 years old or older?* Yes No Emergency ContactName* Relationship* Phone*Name* Relationship* Phone*Volunteer Experience & SkillsHave you ever volunteered or worked for a children’s organization before? If yes, please describe.* Yes No Please Describe*What skills, talents and interests do you have that will help make you a successful volunteer?*What do you hope to gain from your volunteer experience?*About how many hours per week do you wish to volunteer?* Weekly Availability* Sunday Monday Tuesday Wednesday Thursday Friday Saturday Sundays from*Select Time6:00 am7:00 am8:00 am9:00 am10:00 am11:00 am12:00 pm1:00 pm2:00 pm3:00 pm4:00 pm5:00 pmto*Select Time8:00 am9:00 am10:00 am11:00 am12:00 pm1:00 pm2:00 pm3:00 pm4:00 pm5:00 pmMondays from*Select Time6:00 am7:00 am8:00 am9:00 am10:00 am11:00 am12:00 pm1:00 pm2:00 pm3:00 pm4:00 pm5:00 pmto*Select Time8:00 am9:00 am10:00 am11:00 am12:00 pm1:00 pm2:00 pm3:00 pm4:00 pm5:00 pmTuesdays from*Select Time6:00 am7:00 am8:00 am9:00 am10:00 am11:00 am12:00 pm1:00 pm2:00 pm3:00 pm4:00 pm5:00 pmto*Select Time8:00 am9:00 am10:00 am11:00 am12:00 pm1:00 pm2:00 pm3:00 pm4:00 pm5:00 pmWednesdays from*Select Time6:00 am7:00 am8:00 am9:00 am10:00 am11:00 am12:00 pm1:00 pm2:00 pm3:00 pm4:00 pm5:00 pmto*Select Time8:00 am9:00 am10:00 am11:00 am12:00 pm1:00 pm2:00 pm3:00 pm4:00 pm5:00 pmThursdays from*Select Time6:00 am7:00 am8:00 am9:00 am10:00 am11:00 am12:00 pm1:00 pm2:00 pm3:00 pm4:00 pm5:00 pmto*Select Time8:00 am9:00 am10:00 am11:00 am12:00 pm1:00 pm2:00 pm3:00 pm4:00 pm5:00 pmFridays from*Select Time6:00 am7:00 am8:00 am9:00 am10:00 am11:00 am12:00 pm1:00 pm2:00 pm3:00 pm4:00 pm5:00 pmto*Select Time8:00 am9:00 am10:00 am11:00 am12:00 pm1:00 pm2:00 pm3:00 pm4:00 pm5:00 pmSaturdays from*Select Time6:00 am7:00 am8:00 am9:00 am10:00 am11:00 am12:00 pm1:00 pm2:00 pm3:00 pm4:00 pm5:00 pmto*Select Time8:00 am9:00 am10:00 am11:00 am12:00 pm1:00 pm2:00 pm3:00 pm4:00 pm5:00 pmAre you currently a student?* Yes No What school do you attend?* Area of study? Education & Background*Please indicate the highest degree or level of school completed:High School/GEDSome College/Associate DegreeProfessional Degree (i.e. MD, DDS, JD)Bachelor’s DegreeMaster’s DegreeDoctorate Degree (i.e. Ph.D., Ed.D.)Please indicate your current employment status.*Please SelectEmployed Full-timeEmployed Part-timeNot EmployedRetiredOrganization* Position* Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Do you have any special needs or limitations that we should know before you start volunteering? Yes No If yes, please explain:Have you ever been convicted of a felony?* Yes No If yes, please explain:Personal References (please provide 2)Name* Years Known Phone*Email* Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Name* Years Known Phone*Email* Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Reference & Background Check AuthorizationI give permission to contact my references and to conduct a criminal background check:* Yes No By typing my name in the box below, I fully understand and acknowledge that, in volunteering for the Glazer Children’s Museum, I am entering into an AT WILL relationship and that this relationship can be terminated at any time by me or the Museum. To the best of my knowledge all information I have provided is true and complete. 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 or shared. I understand that I may be photographed while volunteering at the Museum and grant permission for the use of my photo or likeness in any Museum publications and approved media sources unless I request otherwise in writing.Applicant Name* If under 18: Parent/Guardian Signature*