Alaska State Parks Standard Volunteer Application

*Other Volunteer/Internship Position 1:

*Other Volunteer/Internship Position 2:

*Other Volunteer/Internship Position 3:

* indicates required fields

Name:

*First

* Last

* Address:

* City:

* State:

* Zip:

* Telephone:

* Message Phone:

* Date of Birth:

Email address:

* Dates Available:
From:

To:

* Are you a citizen of the United States?

* Do you have a valid driver's license?

State

Drivers License Number

* Have you been convicted of a felony within the past ten years?

If you have been convicted within the past ten years, please explain below.

If you have been convicted of a felony, you may not be eligible for volunteer service,
or you may be restricted from performing certain activities.

Do you have an RV or trailer?

* Professional/Volunteer References:

Name

Phone Number

Tell us about yourself. Please describe your background (educational and professional, including any special hobbies, interests, or skills) that may apply to your volunteer service with Alaska State Parks:

* Education:

* Certifications, qualifications, skills:

* Hobbies and interests:

What is your motivation for volunteering?

What do you hope to gain by volunteering with us?

* Has any medical provider limited the scope of your physical activities?
If yes, please describe the limitation:

* Do you have volunteer experience?

* Do you have previous camphost or other volunteer experience, where?

* CPR/First Aid certification and expiration date, if any.

* Past 3 Professional/Volunteer Positions:

Name

Phone Number

Where did you hear about our "Volunteers In Park" program:

Google Search	Former Volunteer	College Career Center
Other

*In case of emergency, please provide the following information

Person's name, address and telephone number (including area code) (not living with you) to be notified:

Emergency Contact Name

Emergency Contact Address

Emergency Contact Telephone Number

Please review this form for accuracy before submitting. If it is correct, click the " I affirm this statement and submit my application" button below. If you accidentally submit an application with errors, please email dnr.pksweb with corrections. Thanks!

All answers and statements are true and complete to the best of my knowledge. I understand that the State may verify information. I agree to perform at least the minimum required activities. I agree to abide by the Department policies as well as the State and Federal laws which prohibit discrimination in employment, education, housing, public accommodation, law enforcement or public service based on religion, race, color, national origin, age, sex, marital status, height, weight, arrest record, or disability.

The applicant affirms that she/he has read the above paragraph and consents to its terms and conditions and that all information provided is correct to the best of the applicant's knowledge.

- A background check may be performed on your application.

- The personal information you provide will be used only for the purposes of managing and administering the Alaska State Park volunteer programs. It will not be used or disclosed by the department for any other purpose.

- Please be aware that e-mails sent to us from this web site are not protected by any special security or encryption.