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Volunteers & Interns  


Butterfly

Milton J. Rubenstein 
Museum of Science & Technology

APPLICATION FOR VOLUNTEER SERVICE

Print out the form from your browser and mail in the completed form to the address below. 
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Send the Application for Volunteer Service to: MOST Volunteer Coordinator
500 S. Franklin Street
Syracuse, NY 13202

__ Internship through _____________________________ (agency or academic institution) 
__ Volunteer service independently
__ Volunteer service through ________________________(agency or academic institution) 
__ Other intended involvement with the MOST* _________________________________

Application Date: ________________________

Name: __________________________________________________________

Address: ________________________________________________________

City: _______________________________ State: _____ Zip: ______________

E-mail (if checked 2x/week): _________________________________________

Daytime Phone: ____________________ Evening Phone: _________________

In emergency, notify: _______________________________________________

Relationship: _________________ Daytime Phone: _______________________

Occupation: ______________________ (company) _______________________

If student, school or college now attending: _____________________________

Grade or level: _____________________
 

Time available:

M: not open  T: _____ W: _____ Th: ______ F: ______ Sa: _____ Su: _____ 

Mornings (11-2): ______ Afternoons (2-5): ______ Other: ________________

Evenings: ____________ Time of year: _____________________________

Area of volunteer interest: Circle your choice(s). 
Note: * means additional training beyond our "intro" is required.
 
Host/explainer of exhibits  Friends (auxiliary) Answering phones *
Admissions Animal care * Bookkeeping/accounting * 
Birthday parties Apothecary Shop team * Database assistance 
Camp-ins Computer Center team *  Exhibit maintenance * 
Omnitheater usher * Demonstrator * Fundraising 
Science camps Planetarium operator * Librarian for Education 
Science Club in schools Radio Station team * Mailings 
Science Store Weekday workshops Photo archives 
Internship (note dept.): __________________ Science Fair Committee

 
Educational background: 
Languages spoken: 
First Aid training (if any, please indicate when, where and qualification attained):
Previous work/volunteer experience:
Skills, hobbies, scientific and special interests:
Date of last tetanus shot: ____________________________________________

Do you have any allergies? ____________ List: _________________________________

How did you learn of the volunteer opportunities at the MOST?
 

Why do you want to volunteer at the MOST?
 

Are you currently a MOST member? ____________

Personal References:
Name Address Relationship  Phone Known how long

1. _________________________________________________________________________

2. _________________________________________________________________________

By signing this application, you are indicating your understanding that neither the Museum of Science & Technology (MOST), the MOST Foundation nor the Discovery Center of Science & Technology assumes responsibility for any injury suffered by you as a result of your volunteer service, and that if you are appointed by the MOST Volunteer Service Program, neither you nor your parents, nor the heirs, administrators, executors of assigns of either, shall ever institute or aid in the institution of any action at law or otherwise against the MOST on account of any injury to you or to your property resulting from your volunteer service.

_____________________________________________________
Volunteer Signature and Date

______________________________________________________
Parent Signature (if applicable) and Date

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