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
Your answer
City *
Your answer
State *
Your answer
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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