Brant Historical Society Volunteer Application Form

Name

Street Address

Telephone

Emergency Contact Name

Telephone

Are you under 18? If yes, please fill out the information below.

Date of Birth (MM/DD/YYYY)

Name of Parent/Guardian

Work Phone Number

Name of Doctor

Telephone

Do you have any special health concerns? (ie. allergies, etc.)

1. When are you available to volunteer?

Weekends	Weekdays	Evenings	Special Events
Summer	Winter	Fall	Spring

Comments

2. What areas of the Museum interest you? Check all that apply.

Cooking/baking	Gardening	Education Programs
Research	Computers	Facility Maintenance
Collections	Office Duties	Interpretive Tours
Sewing	Exhibits	Committees/Board
Craft Demonstrations		Special Events
Fundraising/Promotion

Other interests

3. What skills or experience do you have to offer the museum? Check all that apply.

Computer skills	Maintenance	Education Programs	Sewing
Library Skills	Research	Public Speaking	Clerical
2^nd Language	Writing	Education	Camps
Building/Tinkering		Marketing/Fundraising
Craft Skills. If so, what kind
Are you available to assist with special events?			Yes No

Other skills

4. Do you have access to a car?

Yes No Not Applicable

5. How did you hear about the volunteer program?

6. What do you hope to gain from you experience here? What are your personal goals for your involvement at the Museum?

Please list 2 references that we could contact. Please include their phone number and the nature of the relationship (i.e. employer, teacher etc.)

Name
Phone #
Relationship

Name
Phone #
Relationship

Note: Due to issues regarding the security of the collection, as well as contact with young children, references may be checked, you may be called for an interview or requested to complete a security check.

I hereby declare that the forgoing information is true and complete to my knowledge. I understand that a false statement may disqualify me from the Brant Historical Society's volunteer program, or result in my dismissal. Further, I permit the Brant Historical Society to contact the individuals that I have listed as references to ascertain my suitability as a volunteer.

I Agree

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Travelling Museum

Adult Outreach Program:

Designed to bring the Brant Museum to retirement/assisted-living environments, adult day programs, and adult community groups, the Brant Historical Society's Adult Outreach Program is an interactive way to experience history!

New Themes for 2013!

New monthly themes for the Travelling Museum Adult Outreach Program include:

•Community Spotlight: Brantford
•Community Spotlight: Paris
•Community Spotlight: Mt. Pleasant
•Camping and Survival
•Cookery
•Very Superstitious
Old favourites which are returning for 2013 programs include:

•Lights and Lighting
•Pockets and Purses
•Needlework
•Remembrance Day
•Winter Holidays
•And of course, the Hats!!!
For more information, or to book a presentation, contact Carlie at 519-752-2483 or email carlie.myke@brantmuseums.ca

Themes are subject to change without notice.

Please note: Individual presentations on a specific theme may be delivered upon special arrangement. Presentations may be booked individually, or on a recurring basis.

Hours of OperationSunday - Closed
Monday - Friday - 10am to 4pm
Saturday - 1pm to 4pm

57 Charlotte Street
Brantford, ON N3T 2W6

Phone: 519 752 2483
Fax: 519-752-1931
Email: information@brantmuseums.ca

Website designed & developed by TDG Marketing Inc.

The support of the Government of Ontario, through the Ministry of Tourism and Culture, is acknowledged.


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Brant Historical Society Volunteer Application Form