American Democracy Volunteer Application
Volunteer Application for American Democracy. This volunteer application is used for American Democracy Gallery Guide Volunteers only. Please fill out all areas.

Volunteer Agreement and Certification, Authorization and Waiver must be signed and include the date signed.

A background check will be completed on all American Democracy Volunteers. 


Sign in to Google to save your progress. Learn more
Legal Name (Given Name) First and Last *
Address (physical address, city, state and zip code) *
Phone Number  *
Email Address
May we contact you by phone? *
May we contact you by email? *
Have you ever been convicted of a violation other than a minor traffic violation? If YES please explain. *
Emergency Contact 1 (please include: Name and Phone Number)
 *
Emergency Contact 2 (please include: Name and Phone Number)
Languages you are fluent in? 
Volunteer are needed Tuesday - Saturday 9:00am - 4:00pm with the exception of Thursday 9:00am - 8:00 pm. Days and Times you are available to volunteer during these hours. *
Required
Wavier 

I release and waive any claim or cause of action against any person responding to inquiries authorized herein, and against History Nebraska in making such inquiries. A photocopy of this certification, authorization and waiver shall be as valid as the original and may be used in its stead.

Please review and confirm your understanding *
Required
Electronic Signature *
Date of Signature   *
MM
/
DD
/
YYYY
VOLUNTEER AGREEMENT

I agree to donate my services to History Nebraska, and understand that I will not be paid. I understand that History Nebraska may take photographs of me for publications or other uses. I agree to abide by History Nebraska rules, regulations, and policies, and will work under the direction of its staff towards its mission. I understand that my volunteer services can be terminated at any time. I authorize History Nebraska to investigate all statements made in this application, and to do a background check. I understand that I may have access through my volunteer duties to confidential information. I agree to keep all information that is obtained through my volunteer service at History Nebraska confidential and will not disclose any information to anyone other than my History Nebraska direct supervisor.  Please sign on the line below.

Please review and confirm your understanding  *
Required
Electronic Signature *
Date of Signature   *
MM
/
DD
/
YYYY

CERTIFICATION, AUTHORIZATION & WAIVER

REGARDING BACKGROUND CHECK FOR VOLUNTEERS

Certification 

I certify that all statements in my application, resume and any other document I have submitted for a volunteer position with History Nebraska are true, complete and correct to the best of my knowledge and belief. I further certify that all oral statements I have made or caused to be made to any representative of History Nebraska are true, complete and correct to the best of my knowledge and belief. I understand and agree that ALL statements may be investigated. 

I understand that any falsification or omission of information discovered at any time during the selection process or during subsequent approved volunteer assignments, may bar me from consideration for a volunteer position or, may cause my dismissal from volunteering with History Nebraska. 


Authorization 

I hereby authorize History Nebraska, during the application process or during the course of any subsequent volunteer opportunities with History Nebraska, to obtain information from any public or private source as to my education, experience, qualifications, driving record, criminal history or any other aspect of my background, as such information relates to the position for which I am being considered, or in which I may be assigned as a volunteer. The disclosure of your date of birth provided to History Nebraska is voluntary and will be used exclusively for purposes of the background check. You will not be denied the opportunity to be a volunteer solely on the basis of refusing to provide your date of birth information. 

Please review and confirm your understanding  *
Required
Date of Birth  *
MM
/
DD
/
YYYY
Electronic Signature *
Date of Signature   *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of History Nebraska.

Does this form look suspicious? Report

Google Forms