Fill and Sign the Federal Direct Consolidation Loan Application and Promissory Note Loanconsolidation Ed Form

South Slough Volunteer Application Date: _____________________________ Email _____________________________________ Name ________________________________________ Phone _____________________________________ Mailing Address _______________________________ Over the age of 18? □ Yes □ No Type of Volunteer Service that interests you: Do you prefer: □ Indoor Work City ___________________ State/Zip _____________ *If under 18 years of age, parent/guardian permission required. □ One-time □ Outdoor Work □ Occasional □ Regular □ Either Days/Hours you are available: _____________________________________________________________________ Have you volunteered at South Slough before? □ Yes □ No If yes, when and what did you do? _____________________________________________________________________________________________ What areas of volunteer work most interests you? Check all that apply. □ Front Desk/Greeter □ Landscape/Trail Maintenance □ Guiding Trail Walks □ Assist with Interpretive Programs □ Friends of South Slough Board □ Marsh Bird Monitoring □ Sea Grass Monitoring □ Event Planning/Coordination □ Working with children □ Deliver speaking presentations □ Festival Booth Docents □ Marsh Plant Sampling □ Aquaria Maintenance □ Bird Watching □ Native Plant Gardening □ Exhibit Preparation □ Presence/Absence Monitoring □ Other _____________________ Please indicate the qualifications, experience, skills you would like to contribute as a volunteer: _____________________________________________________________________________________________ _____________________________________________________________________________________________ Are you currently… □ employed? □ in school? Where? _____________________________________________________________________________________ Department of State Lands/South Slough National Estuarine Research Reserve PO Box 5417, 61907 Seven Devils Road Charleston, OR 97420 Phone 541-888-5558 FAX 541-888-5559 www.southsloughestuary.org South Slough Volunteer Application What other community activities are you/have you been involved in? _____________________________________________________________________________________________ _____________________________________________________________________________________________ Educational background and interests (both formal and informal) _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ Health and Safety: Although volunteers are not required to answer the following questions, we want to do everything we can to protect you while you help us protect our natural resources. This information will help us do that. This information will be kept confidential and any information provided is voluntary. Can you swim? □ Yes □ No Do you have experience operating boats? describe) □ Yes □ No Paddle Craft? □ Yes □ No (Please Do you have a history of back trouble? □ Yes □ No (If yes, please explain) _____________________________________________________________________________________________ _____________________________________________________________________________________________ Do you have any allergies of concern? (i.e. bee stings, poison ivy, etc.) _____________________________________________________________________________________________ _____________________________________________________________________________________________ Please describe any other physical conditions that we should know about (i.e. hypoglycemia, diabetes, heart condition, etc.). _____________________________________________________________________________________________ _____________________________________________________________________________________________ Do these conditions affect your activity level in any way? _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ Department of State Lands/South Slough National Estuarine Research Reserve PO Box 5417, 61907 Seven Devils Road Charleston, OR 97420 Phone 541-888-5558 FAX 541-888-5559 www.southsloughestuary.org South Slough Volunteer Application References Please list names and phone numbers of three people who have first hand knowledge of your personality, character and work habits. Name Phone Relationship/# Years Known _____________________________ _________________________ ____________________________ _____________________________ _________________________ ____________________________ _____________________________ _________________________ ____________________________ _____________________________ _________________________ ____________________________ Emergency Contacts In case of an Emergency, accident, serious illness, I would like to have the following person(s) notified: FIRST SECOND __________________________________________ Name Relationship ______________________________________________ Name Relationship __________________________________________ Address ______________________________________________ Address ___________________ Home Phone ____________________ Home Phone __________________ Business Phone _____________________ Business Phone -------------------------------------------------------------------------------------------------------------------------------------------------------Special Provisions: The Volunteer understands that volunteer services will be provided to South Slough National Estuarine Research Reserve and Division of State Lands (DSL) with no monetary or material compensation. Volunteers are not considered employees of the State of Oregon. As a public educational organization, the reserve is dedicated to presenting information in a way that is free of judgment and side-taking. The reserve understands that its staff, volunteers, and training program participants have their own personal opinions. While the reserve does not expect anyone to give up those personal opinions, they must be withheld when you are interacting with our visitors or when you are representing the reserve. This includes refraining from wearing campaign items or promotion of political positions while on duty or representing the reserve. Department of State Lands/South Slough National Estuarine Research Reserve PO Box 5417, 61907 Seven Devils Road Charleston, OR 97420 Phone 541-888-5558 FAX 541-888-5559 www.southsloughestuary.org South Slough Volunteer Application Volunteers are expected to comply with DSL and South Slough NERR department standards of conduct and other applicable rules. Privacy Statement Furnishing the requested information on this form is done voluntarily. The information is considered confidential and will be used only to contact applicants and to interview and select them for appropriate volunteer assignments. Signature ______________________________________ Date ________________________ *If under 18 years of age, parent or guardian must sign below. Parent/Guardian Signature _________________________________ Date _______________________ -------------------------------------------------------------------------------------------------------------------------------------------------------Authorization for Release of Information As part of my application for the South Slough Volunteer Program, I authorize the release of any and all information relevant to my character and/or employment which may be requested in evaluating my qualifications for the volunteer program. I release all parties and persons connected with any request for information from all claims, liabilities, and/or damages for whatever reasons arising out of furnishing such information. Name (please print) : ___________________________________________________________________________ Signature: ________________________________________________________ Date: ______________________ *If under 18 years of age, signature of parent/guardian is required: Name (please print) : ____________________________________________________________________________ Signature: _______________________________________________________ Date: _______________________ Department of State Lands/South Slough National Estuarine Research Reserve PO Box 5417, 61907 Seven Devils Road Charleston, OR 97420 Phone 541-888-5558 FAX 541-888-5559 www.southsloughestuary.org