BAXTER STATE PARK

INDIVIDUAL VOLUNTEER SERVICE APPLICATION

Name:___________________________________________ Date of Birth:____________

Address:_________________________________________________________________

Telephone Number: ______ - ______ - ________ Email: _________________________

In Case of Emergency, Notify:

Name:________________________________________________________________

Address: ______________________________________________________________

Telephone: ______ - ______ - ________

Education: Indicate highest level completed:

Elementary ______ High School ______ College ______ Major ______

Occupation: (Current/Previous) _______________________________________________

Special Skills, Interests & Hobbies: ____________________________________________

Type of Volunteer Activity Preferred:

1.____________________________________________Location in Park: _____________

2.____________________________________________Location in Park: _____________

Periods of Time Available (Dates)

Summer: _________________________________________________________________

Winter: _________________________________________________________________

Personal References: (Name & Telephone Number)

1._______________________________________________________________________

2._______________________________________________________________________

3._______________________________________________________________________

AGREEMENT FOR VOLUNTEER SERVICE

I UNDERSTAND THAT IF ACCEPTED AS A VOLUNTEER:

  1. I shall be subject to all Baxter sState Park Rules & Regulations.
  2. I shall not have the status of an employee of the State of Maine.
  3. I shall not receive compensation for my services.
  4. I will provide all necessary camping equipment and supplies: unless advised of other arrangements by Park staff.
  5. I will be available for a minimum of one week if volunteering as a campground assistant or maintenance assistant and will contribute a minimum of twenty-eight (28) hours of work per week.
  6. I will operate Baxter Park Vehicles and/or equipment only if I hold proper license, have specific permission from and am under supervision of Baxter Park staff.
  7. I shall maintain an appearance and conduct myself in a manner complimentary to Baxter State Park.
  8. I shall not use my status as a volunteer to secure access to areas of the park not accessible to others, for the purpose of obtaining material by camera, video camera, or other means to be used for commercial purposes.

Insurance: All volunteers must be 18 years of age or older to be covered under Baxter State Park volunteer program accident policy. If you have your own health insurance, you can stretch Baxter Park's limited budget by not enrolling in their accident policy program.

Do you wish to be enrolled in BSP's accident plan? Yes ______ No ______

If "no", please list name & policy number of your company:  _____________________________

SIGNATURE OF VOLUNTEER: _____________________________DATE:____________

APPLICATION ACCEPTED: _____________________(Chief Ranger)DATE:____________

APPLICATION REJECTED:  _________________________________DATE: ___________