Youth Volunteer Form
This form is for potential volunteers, aged 14-17. If you are over the age of 18, please fill out our Adult Volunteer Form.
Personal Information
Name (First & Last)
Your answer
Address
Your answer
City/State/Zip
Your answer
Home Phone (xxx-xxx-xxxx)
Your answer
Cell Phone (xxx-xxx-xxxx)
Your answer
Email Address
Your answer
Gender
Date of Birth
MM
/
DD
/
YYYY
T-Shirt Size
Name preferred on ID Badge
Your answer
Languages Spoken
Your answer
Volunteer/Work Experience & Interests
Do you have previous volunteer experience?
Required
Work Experience?
Required
If yes; where, when and in what capacity?
Your answer
Please list any special skills and hobbies that might be useful to the Kansas Children's Discovery Center
Your answer
Please write why you are interested in volunteering at the Discovery Center
Your answer
Education
School
Your answer
Grade Level
Your answer
Expected Graduation Date
MM
/
DD
/
YYYY
Reference Information
Please provide a letter of reference or contact information for one reference that is NOT your parent or guardian.
Reference #1 Name
Your answer
Relationship
Your answer
Phone Number
Your answer
Reference #2 Name
Your answer
Relationship
Your answer
Phone Number
Your answer
Photo Release
I give KCDC permission to photograph me for publication or other uses.
Required
Emergency Contact Information
Name
Your answer
Relationship
Your answer
Phone Number
Your answer
Authorization and Release
To begin my enrollment process as a volunteer with the Kansas Children's Discovery Center, I authorize an investigation of all statements contained in this application as may be necessary in arriving at an acceptance decision. I certify that the information above is true and complete to the best of my knowledge. I understand that my volunteer status may be terminated at any time for failure to comply with policies and procedures of the Discovery Center. I agree to abide by the rules and regulations set forth by the Discovery Center staff and Trustees.
Name
Your answer
Date
MM
/
DD
/
YYYY
By checking this box, I agree that my typed signature serves as my official signature to the above statement.
Required
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