Volunteer Application Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for your interest in volunteering with the Mid-Columbia Children's Museum. Volunteers are crucial for the overall success of our organization.

Please take some time to read over our requirements, and contact us directly at volunteer@mccmuseum.org for any further questions:

- Applicants must be at least 18 years of age

- Must successfully pass a background check. Go to https://watch.wsp.wa.gov/ for more detailed instructions.

Name: *

First and Last

Email: *

Phone Number: *

Emergency Contact Name & Phone Number: *

Special Skills/ Experience (ex: Bilingual, Tech skills, etc):

Additional Information (ex: Limitations, Severe Allergies, etc):

I Agree

I understand and agree that submitting this application form does not automatically register me as a Mid-Columbia Children's Museum (MCCM) volunteer, and that there may be certain qualifications I must meet, including, passing a background check, and the acceptance of established volunteer policies and procedures before I may begin volunteering.

Additionally, I hereby grant permission to MCCM, its respective successors, assigns, and anyone that MCCM may authorize the right to copyright and/or use separately or together my name, photograph, video and/or likeness in, in connection with, or as a part of any advertising, merchandising, packaging, labeling, publicity and trade in any media throughout the world in perpetuity, and in connection therewith, I hereby release them and each of them from all liability unless I request otherwise in writing.

I release MCCM and any of their agents or employees from any and all liability for claims and damages which might arise as a result of personal injuries received in connection with participation in the activities associated with this program.

I certify that my medical information is complete and accurate to the best of my knowledge. I give permission for a MCCM team member to seek emergency care for myself when they deem necessary.

I warrant and represent that I am over eighteen (18) years of age.

By submitting this form, I attest that the information I have provided on the form is true and accurate.

I agree

THE FOLLOWING INFORMATION WILL BE UTILIZED TO COMPLETE A BACKGROUND CHECK THROUGH THE WASHINGTON STATE PATROL "WATCH" PROGRAM.

Full Legal Name (First, Last, Middle Initial)

Former Names or Aliases

Current Address: *

Previous Address (if lived at current address for less than 1 year):

Date of Birth: *

YYYY

Please provide any additional details you wish to share about your criminal history. This information will be kept confidential and will only be used to assess your application. (Please note that if you do not wish to provide these details in writing, we are happy to accommodate a phone interview after your background check has been processed.)

1. Please describe the circumstances surrounding any convictions or pending charges.

2. Provide any relevant context or mitigating factors that you believe should be considered.

3. If applicable, explain any steps taken towards rehabilitation or personal growth since the incident(s).

4. Include any other information you feel is important for us to know.

By providing this information, you can help us better understand your situation and make a fair assessment of your application.

I hereby authorize the Mid-Columbia Children's Museum and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the consumer report/ investigative consumer report may include, but is not limited to the following areas: verification of social security number, credit reports, current and previous residences; employment history, education background, character references, drug testing, civil and criminal history records from the criminal justice agency in any or all federal, state, county jurisdictions; driving records, birth records, and any other public record.

I further authorize any individual, company, firm, operation, or public agency to divulge any and all information, verbal or written, pertaining to me, to the Mid-Columbia Children's Museum or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources. The Mid-Columbia Children's Museum and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicants personal information, including, but not limited to, address, social security numbers, and dates of birth.

"By typing my name below, and submitting this application, I understand and agree that this is a form of electronic signature has the same legal force and effect as a manual signature, and that I am providing consent to Mid- Columbia Children's Museum to run a background check on me.

Applicant's full name:

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Mid-Columbia Children's Museum.

Does this form look suspicious? Report

Forms