Medicine Park Aquarium and Natural Sciences Center Volunteer Docent Application Form
Contact Information
Choose a Title
First Name
Your answer
Last Name
Your answer
Nickname
Your answer
Street 1
Your answer
Street 2
Your answer
Street 3
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City
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State
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Zip Code
Your answer
Home Phone
Your answer
OK to call?
Work Phone
Your answer
OK to call?
Cell Phone
Your answer
OK to call?
Email
Your answer
Demographics
Age Range
Gender
Education
Marital Status
T-shirt Size
School, if applicable
Your answer
Skills and Experience
Please list any skills or past experiences that you feel would make you an asset to the Medicine Park Aquarium.
Your answer
Availability
Please indicate the days and times you are usually available to volunteer.
Required
Emergency Contact
First Name
Your answer
Last Name
Your answer
Phone Number 1
Your answer
Phone Number 2
Your answer
Relationship
Your answer
References
Reference #1
First Name
Your answer
Last Name
Your answer
Preferred Phone Number
Your answer
Email Address
Your answer
Relationship
Your answer
Reference #2
First Name
Your answer
Last Name
Your answer
Preferred Phone Number
Your answer
Email Address
Your answer
Relationship
Your answer
Medical Conditions
Please list if you have any medical, physical, special needs or other problems that may affect your performance. You may be on your feet for several hours at a time.
Your answer
Ability to volunteer
After reviewing the volunteer functions, are you able to do them without reasonable accommodation? If the answer is NO, describe what accommodation would be needed below
Your answer
Background Information
Answer the following questions in the space provided below.
Are you a Registered Sex Offender under the laws of the State of Oklahoma, any other state or with the federal government or a tribal government?
Are you registered under the provisions of the Mary Rippy Violent Crime Offenders Act, or subject to a deferred judgement, suspended sentence, probation or parole from any court of another state, the United States, a tribal court or a military court for any crime or attempted crime which, if committed in the State of Oklahoma, would be a crime similar to any crime enumerated in Title 57 Oklahoma Statutes § 593 B. (If a question of those crimes, please review a copy of the same which will be provided upon your request).
Do you agree to a criminal background check?
The aquarium is a "Drug Free" workplace. Do you agree to a drug screen test?
I Agree
I understand and agree that submitting this application form does not automatically register me as a Medicine Park Aquarium volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering.
By submitting this form, I attest that the information I have provided on the form is true and accurate
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