MUSEUM AMBASSADOR APPLICATION Semester(s): O Fall O Spring O Both Application date:_______ / ______ / __________
Please complete the following information. I. Contact Information Name: _________________________________________________________________________ (last)
(first)
(middle)
Address:____________________________________________________________________________ City:________________ State:______ Zipcode:______________
Telephone: _________________________
Email address:________________________________________ Date:__________________
II. Availability At what times are you available to volunteer for the Museum? Please check all times that apply. Note that the Museum is closed on Mondays; however, please indicate if you are free at any time on Mondays for other Museum related opportunities. *Special Event opportunities will be available on weekends and evenings*
Information Day Monday Tuesday Wednesday Thursday Friday Saturday
9:00-10:00
10:00-11:00
11:00-12:00
12:00-1:00
1:00-2:00
Are you interested in Special Event opportunities on weekends and evenings?
2:00-3:00
O Yes
3:00-4:00
O No
III. Skills/Interests Classification: ________________ Major: __________________________ Minor: ______________________________ Hobbies/Interests/Skills: ______________________________________________________________________________ ______________________________________________________________________________ Group Affiliations: __________________________________________________________________________________ __________________________________________________________________________________ Previous volunteer experience: _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ Have you ever worked or volunteered in a museum?
O Yes
O No
If yes, please complete the following: Institution name: ______________________________
Dates:_______________
Describe your Duties: _______________________________________________________________________________
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Is there a particular type of volunteer work that interests you? Check all that apply. O Art handling O Cataloguing collections O Event publicity O Exhibition installation O General administration O Guided tours O Host special events
O Membership management O Museum mailing O Museum reception desk O Program development O Research O Other __________________________________
Is there a special talent or skill that you possess that will be particularly useful to the Museum? _________________________________________________________________________________________________ _________________________________________________________________________________________________ Is there a specific group you are particularly interested in working with? Check all that apply. O Adults O Children
O Disabled O No Preference
O Senior Citizens O Students
O Other ___________________
How did you hear about the Museum Ambassador Program? O Flyer O Instructor
O Museum staff O Word of mouth
O Faculty O Other___________________
IV. Emergency Contact Information Name:______________________________________________ Relationship: ___________________________________ Phone: ____________________________________ Alt. Phone: ______________________________
V. Signature Sign:_______________________________________________________ Date: _______________________________
Please return completed application to the Museum's administrative offices located on the second floor, Room 218 or the Museum located on the first floor of the Camille Olivia Hanks Cosby, Ed.D. Academic Center Reserved for Museum Staff use
Museum Ambassador Application – page 2 of 2