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Monday	10:00 am – 5:00 pm
Tuesday	10:00 am – 5:00 pm
Wednesday	10:00 am – 5:00 pm
Thursday	10:00 am – 8:00 pm
Friday	10:00 am – 5:00 pm
Saturday	10:00 am – 5:00 pm
Sunday	10:00 am – 5:00 pm

Monday	10:00 am – 5:00 pm
Tuesday	10:00 am – 5:00 pm
Wednesday	10:00 am – 5:00 pm
Thursday	10:00 am – 8:00 pm
Friday	10:00 am – 5:00 pm
Saturday	10:00 am – 5:00 pm
Sunday	10:00 am – 5:00 pm

I certify that answers given herein are true and complete to the best of my knowledge. I authorize an investigation of all statements contained in this application as may be necessary in arriving at an acceptance decision. In the event of acceptance, I understand that false or misleading information given in my application or interview may result in dismissal from the volunteer ranks. I am aware that acting as a volunteer does not make me an employee of Exploration Place. I understand, also, that I am required to abide by all rules and regulations of Exploration Place. As a volunteer, I agree to hold as absolutely confidential all privileged, and or sensitive information which I may obtain directly, or indirectly concerning Exploration Place, its guests and staff (including employees and volunteers).
Full Name*
I authorize Exploration Place to receive information from the Kansas Bureau of Investigation and any law-enforcement agency, including police departments and sheriff's departments, of this state or any other state or the federal government, to the extent permitted by state and federal law, pertaining to any convictions I may have had for violations of state or federal criminal laws, including but not limited to convictions from crimes committed upon children. I understand that such access is for the purpose of my application as a volunteer, and that I expressly DO NOT authorize Exploration Place, its directors, officers, employees or volunteers to disseminate this information in any way to any other individual, group, agency, organization or corporation.
I certify that I have read and agree to the statements above.
Full Name*
Date*
Applicant is under 18. He/She has my permission to become a volunteer at Exploration Place
Parent/Guardian Full Name
Date

VOLUNTEER INTERVIEW AND ACCEPTANCE PROCEDURE

All potential volunteers must complete a general orientation training session prior to being accepted to the program. This is a selection process and not all applicants are accepted into the program. We reserve the right to place volunteers in the area best suited to their skills and the needs of the museum. You have the right to decline the assignment and wait for one you prefer. Those who would like to work as Explorer Guides must complete additional training specific to the chosen area or traveling exhibit. Other positions will require various levels of on-the-job training provided by the supervisor of that area. We look forward to your volunteer participation at Exploration Place.
Personal Information
Are You a Member?*
Prefix*
First Name*
Last Name*
Date of Birth*
Home Address*
Street Address City State / Province / Region
Home Phone
Work Phone
Cell Phone
Do you prefer to receive calls at:*
May we leave messages for you or call you at work if we need to contact you short notice?*
Email*
VOLUNTEER EXPERIENCE
Do you have previous volunteer experience?*
List up to three places you have volunteered and what kind of volunteering activity you performed there
VOLUNTEER EXPERIENCE 1
VOLUNTEER EXPERIENCE 2
VOLUNTEER EXPERIENCE 3

REFERENCES
Please list two work, school, or personal references, not relatives, whom we may contact regarding your application.
Reference 1 Full Name*
Reference 1 Relationship*
Reference 1 Address*
Reference 1 Phone*
Reference 2 Full Name*
Reference 2 Relationship*
Reference 2 Address*
Reference 2 Phone*
EDUCATION
Highest year completed or current year in High School*
Highest year completed or current year in college*
Highest degree earned
Major
Name of School
List any other formal training, skills, or experience that might be pertinent to volunteering at EP
MEDICAL EMERGENCY INFORMATION
Primary 1 Contact Name*
Primary 1 Relationship*
Primary 1 Contact Cell Number*
Primary 1 Contact Home Number
Primary 1 Contact Work Number
Primary 2 Contact Name
Primary 2 Relationship
Primary 2 Contact Home Number
Primary 2 Contact Work Number
Primary 2 Contact Cell Number
Personal Physician Name*
Personal Physician Number*
Hospital preference*
Please list any allergies, special medical needs or conditions that would be relevant during emergency situations
It is the policy of Exploration Place to comply with all applicable local, state and federal laws prohibiting discrimination in employment/volunteering based on race, religion, color, sex, age, national origin, disability or any other protected classification.

EMPLOYMENT HISTORY
I am:*
Employer*
Occupation*
Please complete this section of the form as it is applicable to your employment situation:
Company Address
Street Address City State / Province / Region
Telephone
Name of supervisor
May we contact you at work?
Would you like us to keep your employer informed of your volunteer services?
Does your employer offer a time-off program for volunteers?
Does your employer (OR FORMER EMPLOYER, IF RETIRED) offer a donation matching program?
Have you ever been employed at Exploration Place?
When?
Position
Do you have friends or relatives currently employed or volunteering at Exploration Place?
Name
Relationship
Name
Relationship
COMMUNITY SERVICE VOLUNTEERING
(Exploration Place does not offer court-mandated volunteer services)
If you are here through a community service program (school, club or organization) please indicate the following.
Name of school or organization
School/Organization Address
Street Address City State / Province / Region
Telephone
Supervisor/Contact name
How many hours are you required to volunteer?
By what date must you complete the required hours?

Step 1 of 4

VOLUNTEER INTERVIEW AND ACCEPTANCE PROCEDURE

Personal Information

VOLUNTEER EXPERIENCE

REFERENCES

EDUCATION

MEDICAL EMERGENCY INFORMATION

EMPLOYMENT HISTORY

COMMUNITY SERVICE VOLUNTEERING

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