GENERAL INFORMATION
Last Name: _________________________ First Name: _______________________
M.I.:_____
Address: __________________________________________________________________________
City: ____________________ State:______
Zip: _______________
Home Phone #:________________________ Cell
#: _____________________
May we e-mail you? Y N
Museum Member: Y N
E-mail ____________________________________
In case of emergency, notify:
Name: _________________________________
Phone: ___________________________
INTERESTS & EDUCATION
How did you learn of the
volunteer opportunities at the Lake Eustis Museum of Art? ___________________________________________________________________________________
Profession or school if student:__________________________________________________
Please describe your volunteer history: ___________________________________________________________________________________
Why do you want to volunteer with us? ___________________________________________________________________________________
Highest level of
education completed:____________________________________________________
Special
skills, talents or interests related to the art museum, education, office and events setting:
_________________________________________________________________________________________
AVAILABILITY
Are you available: ___Full Time ___Part Time
___Temporary
# of Desired Weekly Hours: _________
Which do you prefer?
__ Mornings __ Afternoons __Weekends
__Evenings (Limited to special events)
What are your preferred days? (Check all that apply.)
__Tues. __Wed. __Thurs. __Fri.
__Sat. ___Sun. ___Mon.
TYPES OF VOLUNTEER WORK
Gallery: ___Visitor Services/Greeter
Special Events: ___Exhibition
Openings
___Other
Development/Marketing: ___Bulk Mailings ___Materials Distribution
___Membership Team
___Other
Education: ___Museum School Assistant ___Art
Camp
___Other
Building Maintenance: ___Cleaning ___Painting ___Other
___Cleaning ___Painting ___Other
Office/Computer Support: __Excel ___ Graphic Arts ___
Web Site and E-mail
__ Museum Shop
___ Volunteer Coordinator ___ Membership Coordinator
APPLICANTS UNDER THE AGE OF 18 MUST add the following parental consent:
Parent or Guardian's Name:____________________________________________________________
Address: __________________________________________________________________________
City: ____________________ State:_____
Zip: _______________
Home Phone #:________________________ Business
Phone #: _____________________
Applicant's Date of Birth: (mm/dd/yy) ____ / ____ / ____
My child has my permission to participate as a Lake Eustis Museum of Art volunteer or intern. I hold
harmless and agree not to hold the Lake Eustis Museum of Art responsible for any accident or illness involving my child. The
agreement shall be construed and regulated under and by the laws of the State of Florida.
___ I Agree Signature:
___________________________________________
Date: ____________
ADDITIONAL INFORMATION
A criminal-history is required
for acceptance as a volunteer. The Lake Eustis Museum of Art does not accept court-appointed volunteers.
Please certify and sware to the following: I have never been arrested, charged of convicted of a felony
and have never been accused of perpetrating a violent or sexual crime against any person of any age: Signature_____________________________________________
Date _____________
Please read the following and sign below:
As a Lake Eustis Museum of Art volunteer, I hold harmless and agree not to hold the Lake Eustis Museum of
Art responsible for any accident or illness. The agreement shall be construed and regulated under and by the laws of the State
of Florida.
___ I Agree Signature: __________________________________________
Date: ____________
Please print the completed form and mail to:
Lake Eustis Museum of Art
Attn: Volunteer Opportunities
200 B East Orange Avenue
Eustis, FL 32726
