GIBBON CONSERVATION CENTER

Name   Home Phone   Birth Date
Address, City, State, Zip  
Email  
Occupation/Employer   Work Phone
Work Address  
Closest Relative or Contact Person   Contact's Phone  
Contact's Address

Two References (employers, professors, supervisors):
1. Name   Position
Email (preferred)   Phone (US only)
2. Name   Position  
Email (preferred)   Phone (US only)

Educational background  
Office Skills (typing, computer, etc.)
Trade Skills (carpentry, chain link, welding, etc.)
Animal experience, hobbies, other skills

What languages do you speak, other than English?  
Where did you hear about us?  
Other volunteer service (organizations, board positions, etc.)
Have you ever been away from home for at least a month? Yes No

What do you expect to do here, and what do you hope to gain from your experience at GCC?
 

I am volunteering for the position of Primate Keeper Center Assistant Clerical Assistant as a Resident Volunteer Part-time, commuting, volunteer
If "Resident Volunteer" when do you want to come? (1 month minimum)
1st choice 
2nd choice
If "Part-Time Volunteer", how often can you work? Regular schedule As needed (for example, one day per week, and/or, for special projects.  To choose both, press the "shift" key.)
Please elaborate on your schedule preferences:

I am currently a member of these organizations: none AZA AAZK ASP other organizations
If "other organizations", please name

Have you ever been convicted of any crime? no yes
If yes, please explain when, where, what kind, and disposition of case
Have you ever had any injuries, or physical, sensory or mental restrictions or disabilities? no yes If "yes", please explain
Do you have a suppressed or compromised immune system? no yes not sure If "yes" or "not sure",  please explain

I understand a $200 deposit is required 3 months ahead of start date from volunteer applicants upon acceptance (check for yes)
I understand that smoking is not permitted on the Gibbon Conservation Center property (check for yes)
I understand that I must send (not fax) a copy of proof of health insurance, and a copy (not fax) of my driver's license or other photo identification to GCC for this application to be complete (check for yes)   (Documents may be emailed to volunteer@gibboncenter.org  or mailed to PO Box 800249, Santa Clarita, CA 91380)
Date today  

 
Thank you!  We will begin right away to evaluate your application, contact your references and let you know the outcome.  We appreciate your interest in working with, and helping, the endangered gibbons.