Fps-A065 - Florida Department Of Environmental Protection Volunteer Application

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Florida Department of Environmental Protection
Florida Park Service
Volunteer Application
Date:
Purpose for Volunteering
 Internship
 Give back to the community
 College educational requirement
 Campground host or
resident voluntee
r
 K-12 educational requirement
 Project for scouting or service group
 Community service: Court-ordered
I am a:
New ApplicantReturning Volunteer
Applicant Information
(Please submit a separate application for each individual)
Applicant Name (Last name, first name, middle initial)
Telephone (Best)
Address
City
State
Zip Code
Date of Birth (DOB)
Do you have a valid Driver License?  Yes  No
Email Address
(Required for some duties)
Emergency Contact Information
Name
Relationship
Telephone (Best)
References
(List references that are familiar with your work or volunteer experience. Do not include relatives.)
Name
Telephone(s):
Name
Telephone(s):
Name
Telephone(s):
Locations in which you are most interested in volunteering
(Florida State Parks)
1.
2.
3.
Are you willing to consider volunteering at other Florida State Parks?  Yes  No
Availability
Year you are applying for: __________________
How many hours per week can
Check-off the month(s), day(s) of the week and time you are available:
you volunteer?
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Less than 10
10 to 20
Sun Mon Tue Wed Thu Fri
Sat
AM PM
20-30
30-40
Is your availability flexible?  Yes  No
Campground Host or Resident Volunteer
(Note: Maximum 16-week stay in any single park.)
Complete this section only if you are applying to be a Campground Host or Resident Volunteer.
Type of camping unit:
 Motor Home
 5th Wheel
 Trailer/Camper
 Tent
Length or width of unit (including slide out): L _______ W _______
Extra Vehicle?  Yes  No
RV minimum hook-up necessary:
 Water
 Sewer
 Electricity
Amps Needed: __________
Will you have a pet?  Yes  No If yes, type and breed:_________________________________________
Number of people (including applicant) that will be residing at the campsite: Adults______ Youths______
Name(s) of others residing with you:
DOB:
Name:
DOB:
Name:
DOB:
FPS-A065 REV 12/2012

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