(Please print and fax the completed form to 713.529.6481)

Volunteer Application

Fields marked * are required.

First Name: *                        Last Name: *  

Address: * 

City: *    State: *    Zip: *

E-Mail Address: *           BPA Member?

Phone Numbers:  Home:   Work   Cell

Please indicate which is the best method to contact you?   E-Mail       Home Phone        Cell

Are you 18 years old, or older?    Yes          No

Education (highest level): indicate if you are currently a student

Relevant Work Experience:

Time you have available for volunteering:

Mornings (9:00 am - noon) (earlier for some outdoor projects):

Monday   Tuesday    Wednesday   Thursday   Friday   Saturday   Sunday

Afternoons (noon to 5:00 p.m.)

Monday   Tuesday    Wednesday   Thursday   Friday   Saturday   Sunday

How often are you available to volunteer?

Weekly  Hours/Week      Monthly Hours/Month      Occasionally (as needed)

Please indicate your areas of interest:

Administrative 

Computer       Public Inquiries 

Publicity 

Assist with Special Events           Information booths        Fundraising 

Public Service Announcements       Press Releases        Gala 

Education Programs

School Groups         Field Trips             Youth Events 

Scout Groups           Outreach Programs         Nature Camps 

Outdoor 

Bayou Cleanup         TrashBash®     Removal of Invasive Species     Tree planting       Stream Restoration  

Trash removal 

Previous Volunteer Experience

Please describe and special skills and qualifications you have from training, employment, previous volunteer work, sports, hobbies or special interests:

Languages:

First Aid Training/CPR Certification             Valid Certificate

What would you like to gain from your volunteer experience with the Bayou Preservation Association?

Emergency Contact Information

Name:           Relationship:

Address:

Phone Numbers:  Home:   Work   Cell

Volunteer Release Statement

All volunteers will be asked to sign the following statement before beginning to volunteer.

Volunteers under the age of 18 must also have the signature of a parent or guardian.

As a condition of my participation in the Bayou Preservation Association Volunteer Program, I hereby release the Bayou Preservation Association and its agents, associates, and related parties from all responsibility for personal injuries to me and damages to my property sustained in the performance of my volunteer activities.  The Bayou Preservation Association does not provide any medical, health or accident insurance for its volunteers.  I understand that a criminal background check will be conducted by Bayou Preservation Association as standard procedure.

______________________                                            _______________________________________
Date                                                                                     Signature

                        

Print this page and mail or fax it to:

Bayou Preservation Association

P.O. Box 131563

Houston, Texas 77219-1563

Fax: 713.529.6481