Midway Volunteers: Registration

VOLUNTEER APPLICATION
First Name:*	Last Name:*
Nick Name:
Create your username:*	Create your Password:*
Confirm Password: *	Address:*
City:*
State:*	Zip:*
Phone Number:*	Email:*
Current/Former Occupation:*	Employer:*
Accomplishments:	CurrentFormer
Military Service?:

Specialty:	Rate/Rank:
Service start Date:*	Ships served and/or aircraft flown:
Service end Date: *	Midway Crew

table#rblstaffrefference

Education (check level completed)
High School College Graduate School	Major: Are you over 18?: * YESNO

Health Issues

Do you have any health issues or physical limitations, such as inability to climb ship's ladders?* If YES check the checkbox and provide details NO * In Case of Emergency, please notify: (list name, relationship and phone numbers)
Emergency Contact Name:*	Relationship:*
Phone Number:*
Have you been convicted of a criminal offense other than minor traffic violations?: * YESNO If YES please explain:*

References

Referred by Midway Volunteer/Staff *

YESNO

Please list names and phone numbers of two references whom we may call(business or personal, but not family members)

References Name * Reference Contact No *

References Name Reference Contact No

Have you visited the USS Midway Museum?:

YESNO

Have you read the Volunteer Opportunities list on our website?:*

YESNO

If NO, please review the Opportunities list before completing this application. A copy of the list is available on www.midway.org, under the "GIVE & JOIN - VOLUNTEERS" tab.

Departments
Please let us know which departments you would prefer to work in. You may choose up to three, or as few as one. We will do our best to match your skills and experience with open opportunities we currently have.*

Preferred Department #1:	Which days are best for you to work? * WeekdaysWeekends
Preferred Department #2:
Preferred Department #3:

Skills/Experience/Interests
General Maintenance	Welding
Plumbing	Electrical
Metalworking	Machinist
Communications	Library Science
Teaching	Crowd Control
Public Speaking	Mechanic
Customer Service	Writing
Typing	Aviation
CPR/First Aid	Accounting
Carrier Experience	Acting
Foreign Language Skills *	Multilingual language Known: *
Other :

Where did you hear about the Midway Museum volunteer program? (Check Any)

Friend	Newspaper Article
Visit to Midway	Poster
Volunteer Match	Other *
I understand that any false information submitted in this application may result in my discharge. I also understand that the volunteer program is subject to government regulations. I hereby waive my right to claim that any request or investigation is an invasion of privacy, since they are made with my consent and it is in my best interest that I be considered for a volunteer position. I hereby acknowledge that I have read and understood the above statements.

Applicant’s Signature: *	If you would like to upload your latest or previous working life resume, please do so with the Choose File link below. This can help us determine where your skill and talents best fit in our Volunteer Program.
Date	Resume Upload

VOLUNTEER APPLICATION

Please read volunteer opportunities before completing

*