The Mariners' Museum: Newport News, Virginia

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E-Mail
First Name
Last Name

Zip Code

Possible Start Date

Personal Information

Last*	M.I.	First*

Preferred Name	Spouse's Name

Date of Birth

Contact Information
(students should enter local address and phone number)

Street Address

City	State.	Zip

Telephone*	Cell Phone	E-Mail Address

Emergency Contact
Name	Telephone

Education

Highest Level of Education	Field of Study

Degree Received	Year of Completion

Employment/Volunteer Information

Are you currently employed?
yes no

Number of hours you work each week

Previous/Current Employer's Name

Employer's Address

Employer's City

Employer Reference We Can Contact

Name	Phone

Position Responsibilities
(If retired, please describe responsibilities of former position)

Volunteer Information / Civic Organizations

List any organizations for which you currently volunteer or have previously volunteered or any organizations to which you belong:

Please list one person from any one of your listed orgnaizations above that we may contact as a reference:

Name	Phone

Interests/Skills

working with pre-school children	special events planning
working with elementary school children	music instrument
working with teenagers	carpentry/woodworking
working with senior citizens	exhibit construction
working with handicapped	arts and crafts
office work reception recordkeeping copying/filing	newsletter composition/production
computer data entry	cleansing/restoration of artificats
organizational skills	research
public speaking	manual labor
drawing/painting	calligraphy

What other skills or interests do you have that you would like to use in your volunteering?

Foreign Language

	Fluent	Read	Write		Fluent	Read	Write
French				Chinese
Spanish				Italian
German				Sign
Japanese

Other

Availability

How many hours per week do you wish to docent/volunteer?

If you do not want a weekly schedule, what is your preference?
Bi-Weekly Monthly On-Call

Please use the grid below to show your current availability
to serve as a docent and/or a volunteer.

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
morning
mid-day
afternoon
special events

Do you have any restrctions which the museum staff should be aware of before trying to assign you to volunteer tasks?

Exhibitions & Collections

Visitor Info.

Library

Educational Adventures