Wednesday, 08 September 2010
Staatsburgh
State Historic Site
Volunteer Registration
Form
Name(s)
*
Address
Email Address
*
Telephone Number
(Day)
(Evening)
(Please indicate your preference as to when/where to call you)
Social Security Number
(This is needed in order to obtain coverage for Worker's Compensation.
Your Social Security Number will be held in confidence.)
Is this your first experience volunteering at an historic site or other cultural institution?
If no, where and for how long have you volunteered?
What are your interests and hobbies?
In what way(s) would you like to volunteer for Staatsburgh?
Volunteer Interpreter (Guide)
Museum Store Volunteer
Hospitality Volunteer
Friends of Mills Mansion Food Wagon Volunteer
General Office Volunteer
Special Programs
Other
(Please specify)
What times and days are you generally available to help out?
What times and days are you unavailable?
Would you be interested in volunteering on a regular schedule?
If yes, when?
Do you have preferences you would like us to note?
(i.e. prefer to be seated, prefer not to drive at night)
Aside from these materials, is there other information you would like to receive?
What kind of volunteer activities would you be interested in attending?
Informative lectures or presentations
Visits to other sites
Social gatherings
Other (please describe)
How did you hear of the volunteer program at Staatsburgh?
Other comments?
We thank you for your interest in helping us to preserve this magnificent cultural resource and for your help in educating the public about it.
If you prefer, please print and give your completed Volunteer Registration Form and New York State Volunteer Service Agreement to a member of the staff or mail them to:
Dawn D'Alessio
Staatsburgh State Historic Site
P.O. Box 308
Staatsburg, NY 12580
or fax them to: 845-889-8321 attn: Dawn D'Alessio, Staatsburgh
Old Post Road - Staatsburg, NY 12580 - (845) 889-8851 -
webmaster@staatsburgh.org
