test Leave a reply YOUR NAME YOUR ADDRESS CITY ZIP CODE HOME PHONE NUMBER CELL PHONE NUMBER EMAIL ADDRESS SCHOOL YOU ATTEND (ages 12-18 only) PARENT/GUARDIAN NAME (ages 12-18 only) PARENT/GUARDIAN EMAIL ADDRESS (ages 12-18 only) PARENT/GUARDIAN PHONE NUMBER (ages 12-18 only) BIRTHDAY (month/day/year) WHEN CAN YOU START? AVAILABLE TO VOLUNTEER (check all that apply) Morning Afternoon Evening SPECIFIC DAY & HOURS HAVE YOU EVER BEEN CONVICTED OF A FELONY? Yes No IF YES, PLEASE EXPLAIN DO YOU HAVE A FOOD HANDLER'S PERMIT? Yes No This is required for concession workers. If you do not have a food handler's permit, we will give you information on how to get one. The cost is $25 and it is good for three years. PLEASE LIST ANY JOB OR COMMUNITY SERVICE EXPERIENCE, SKILLS, QUALIFICATIONS OR SCHOOLING YOU FEEL WOULD HELPFUL IN SERVING AS A SCERA VOLUNTEER/INTERN: HOW WERE YOU REFERRED TO SCERA? / WHY DO YOU WANT TO WORK AT SCERA? REFERENCES: (not relatives) - Please list at least two names and phone numbers: VOLUNTEER / INTERN OPPORTUNITIES (check areas you are most interested in) SCERA Center for the Arts (Year-round) - Ushers, Concession workers, Box office SCERA Arts Education Programs (Year-round) - Assistants & Support staff for drama, music, art, dance Technical & Production (Year-round) - Sound, Lights, Costumes, Props, Stage Management, Set Construction/Painting SCERA Shell Outdoor Theatre (Summer) - Ushers, Concessions workers, Box office - MUST BE 14 YEARS OR OLDER AS A VOLUNTEER/INTERN, YOU ARE NOT COVERED BY WORKER'S COMPENSATION INSURANCE. DO YOU OR YOUR FAMILY HAVE HEALTH INSURANCE? Yes No YOUR PERSONAL OR FAMILY MEDICAL INSURANCE COMPANY: INSURANCE POLICY # PLEASE READ THE FOLLOWING STATEMENTS AND CHECK THE BOXES BY EACH BEFORE YOU SUBMIT YOUR APPLICATION: * SCERA has purchased an insurance policy to cover all our volunteers/interns at the SCERA Center for the Arts and the SCERA Shell Outdoor Theatre. This coverage is provided to the volunteer/intern and covers any accidents which might occur while volunteer/intern is participating in any SCERA program. You, as a volunteer/intern, should not perform any act which you consider unsafe. As a volunteer/intern of SCERA, I acknowledge by my signature that I am not covered under Worker's Compensation Insurance. Consequently, if I sustain an injury while acting within the scope of my duties as a volunteer/intern, I can only look to the volunteer insurance policy to cover any damages I might incur. Furthermore, I agree to hold SCERA harmless from any damages that I might incur as a result of injuries I sustain while acting as a volunteer/intern. A volunteer/intern is defined as a person who gives services without any express or implied promise of compensation. The services I provide to SCERA are provided of my own free will and I expect no renumeration or payment from SCERA. SCERA reserves the right to conduct a background check on prospective volunteers/interns age 18 and older. Volunteer/intern opportunities may be contingent upon satisfactory background checks. I attest that the information I have provided is true and accurate and that I agree with the above-stated conditions. reCAPTCHA If you are human, leave this field blank. Δ
