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

Please enter
anti-spam code: "nospam"

Sponsors

The Brant Historical Society would like to thank its corporate sponsors for their support during the past year.

Platinum Sponsors ($2500+)

Gold Sponsors ($1000 - $2499)

Silver Sponsors ($500 - $999)

Copper Sponsors ($50 - $249)

Ancient Moves Dance Co. and Studio
Awakened Wellness
Buffalo Sabres
Cards by Laura
Jamie Daglish – Sun Life Financial
Grand River Chorus
Hamilton Tiger Cats
J. H. Young
Jack Jackowetz
Kneaded Care Inc.
Myrtleville Neighbourhood Association

Ludlow’s Men’s Wear
Musango Advertising
My-Thai Restaurant
Pamela deVries Designs
Serenity Country Candles
Stedman Community Bookstore
Taal Fine Indian Cuisine
Tiger-Cats Football Club
Tipperary Bog
Toronto Blue Jays Baseball Club

Foundations

Cowan Foundation
Brant Community Foundation
Samuel Stedman Foundation

Supporters

Canadian Heritage - Young Canada Works
- Museums Assistance Program
Service Canada – Canada Summer Jobs
Ontario Ministry of Culture - Community Museum Operating Grant
- Ministry of Tourism and Culture
Ontario Trillium Foundation
County of Brant

City of Brantford – Operational Grant
- Community Grant Program
Enterprise Brant
Heritage Canada Foundation
In Kind Support
G.K. York
King & Benton
St. Leonard’s Summer Jobs for Youth

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.


First Name		Last Name
Email
Questions/Comment?
Please enter anti-spam code: "nospam"

Brant Historical Society E-News Sign Up

We Want Your Feedback!

Contact

Brant Historical Society Volunteer Application Form