Volunteer Application
* Required Fields
Contact Information:
* First Name 
* Last Name 
* Address 
* City 
* State/Province 
* Zip/Postal Code 
* Best Contact Phone# 
* Email 
* Date of Birth 
  Student?     School/Program   Grade Level 
  If No, Occupation?   Professional Training/Degree 

Areas of Interest - Please check all that apply:
  Children's Activities   Community Relations 
  Special Events   Birthday Parties 
  Challenger Learning Center - Flight Assistant   Summer Camp 
  Other (specify below) 
  Other Interests 

Availability - Check which days and time you are available
(Most of our volunteer opportunities will occur during the weekend):
  Morning   Afternoon   Evening 
  Sunday   Monday   Tuesday 
  Wednesday   Thursday   Friday 
  Availability Comments: 

  Organization   Job Title/Responsibilities 
  Organization   Job Title/Responsibilities 

References: Please list two references (Other than family members)
  Name   Phone # 
  Organization   Relationship to Volunteer 
  Name   Phone # 
  Organization   Relationship to Volunteer 

Additional Volunteer Information:
  How did you hear about us? 
  Why do you want to volunteer? 
  What skills and qualifications do you have that make you a great volunteer? 
  What do you hope to gain from the experience as a Science Center volunteer? 
  Have you ever been arrested or convicted of a crime related to children, drugs, or violence?   
  If Yes, Please explain: 
  Do you have any physical needs
that require special arrangements? 
  If yes, please explain 

Check the box 'I agree' to indicate that you understand and agree that if you are age 21 or older, you may be required to submit a background check with fingerprinting, and that this will be at your own expense
  I UNDERSTAND and AGREE to background check if 21+    
  I also AGREE to commit to assignments for min of 6 months    

The Powerhouse Science Center welcomes all volunteers ages 14 and over.  Volunteers who are under the age of 16 must be accompanied by a legal guardian at all times.  Volunteers are chosen on an as-needed basis. Submission of this application will not guarantee a placement. Volunteers must attend an orientation and will be placed according to their qualifications and skills. The Powerhouse Science Center Discovery Museum campus will determine volunteers eligibility. Screening may include reference checks, fingerprinting, background checks or other according to placement. By signing below, you are granting permission to complete any and all necessary reference checks and screening required for assignment. Screening requirements are subject to change at any time. 
Upon acceptance you will need you to sign a physical copy of this application as a part of the interview process.  Volunteers under the age of 18 must also provide parental/guardian consent.   
Privacy Policy
We keep your personal information private and secure. When you submit this form, your name, contact information, and any additional information will be available only to our organization.

Contact Us: Powerhouse Science Center •• 3615 Auburn Blvd. Sacramento, CA 95821 •• 916.808.3942 ••
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