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Conservation Crew Internship (CCI) Application 2017
Thank you for your interest in the summer Conservation Crew Internship (CCI) at the Douglas-Hart Nature Center.
Please read the Conservation Crew Internship program requirements (brochure) before applying.
Indicates required field
Grade completed in school:
Are you 18 years of age or older? (You must be 13 to participate on your own).
Phone Numbers: List ALL numbers by which we can reach you or your parents (if under 18).
Your Personal Cell:
Parent's Cell (list their name, too):
Parent's Cell (list their name, too):
Other (please describe):
Check the method(s) you prefer to be contacted by:
Allergies, asthma, and other medical conditions we should be aware of:
Emergency Contact Phone Number:
Conservation Interests & Skills
Check all of the following statements that describe your CCI expereience level:
This will be my first volunteer experience at Douglas-Hart.
I have volunteered at Douglas-Hart or Friendship Garden before.
I have completed (20 hr goal) this internship before.
How did you hear about the Conservation Crew Internships? (Check all that apply)
From my previous invovlement with the JCI program.
From a staff member at Douglas-Hart.
From a teacher or school counselor.
From a friend who recommended it.
If you answered "from a friend," "from a teacher," or "other," please list their name or explain here:
Current Occupation (optional):
Future Career Goal (optional):
Education Background (i.e. high school attended):
Do you have any previous experience in volunteering, conservation projects, or gardening? Please describe in brief.
Please describe in your own words why you would like to complete the Conservation Crew Internship this summer:
Declaration of History
Are there any past or pending criminal charges against you?
Have you ever been convicted for a felony offense?
Have you ever been charged with child abuse or neglect?
Have you ever been charged with a sexual crime?
Is there anything else that we should know about your history or health?
Use this space to explain any questions you answered "YES" to. If you would rather discuss your answer in person, write "see me." For ALL criminal charges, please list the city and state, or county.
To complete this internship, you will need to accumulate a minimum of
with the Conservation Crew between
We do not expect you to schedule every week of the summer.
Your 20-hour goal can be achieved in as few as 8 shifts! However, there is no maximum and you are encouraged to continue your experience beyond 20 hours. We do recommend spreading your efforts over the entire summer, to gain the most experience with different projects and skills.
What you can Expect for Scheduling:
You must RSVP for each shift you plan to attend. This allows staff to plan and prepare appropriately.
Scheduling is flexible to fit your needs! You can arrange a re-occurring weekly schedule, or you can select each of your shifts separately.
You may sign up for shifts in person, via phone or email, or using our online CCI calendar. You will be sent a link to the online calendar at the beginning of your internship.
We will publish a project schedule 2 weeks out, to help you know what to expect each shift and to dress appropriately. The schedule will be made weekly and will address the following 2 weeks. (Weather and other factors
change the scheduled project, even at the last minute.) You will be able to view the schedule online or at the Nature Center.
The Conservation Crew works together at the
Meet inside the Visitor Center.
The Conservation Crew also works at
in Mattoon. This garden is managed by the Douglas-Hart Foundation.
Meet at the garden for these shifts.
Friendship Garden is on the corner of 17th Street & Lafayette Avenue in Mattoon, behind the Burgess-Osborne Auditorium.
Your Predicted Availability:
Please use this section of your application to give us an idea of your availability this summer.
Do your best to estimate your availability for now.
You will not be committed to this schedule yet.
If you need shifts outside of the suggested times (see below), we can arrange custom options.
Check the boxes for the shifts that you expect would be options for you.
MONDAYS, 8:30am-11:00am @ Douglas-Hart
MONDAYS, 1-3pm @ Friendship Garden
TUESDAYS, 8:30am-11:00am @ Douglas-Hart
WEDNESDAYS, 8:30am-11:00am @ Douglas-Hart
THURSDAYS, 8:30am-11:00am @ Douglas-Hart
THURSDAYS, 1-3pm @ Friendship Garden
Check the boxes for the special Saturday shifts that might interest you:
Sat., May 27, 9:00-11:00 a.m.
Sat., June 24, 9:00-11:00 a.m.
Sat., July 22, 9:00-11:00 a.m.
If you CANNOT attend during the suggested shifts, use this box to indicate what days and hours you are usually available.
When would you like to start? (i.e. "now," or "in June," etc.)
Social Events (optional)
Check the social events you are interested in attending:
Conservation Crunch breakfast & speaker (Tuesday, June 13, 8:30-10am)
End-of-the-Summer Family Potluck & Open House (Sat., August 12, 12-2pm)
Reward Field Trip to Scovill Zoo! (Sat., July 29, 9am-3pm)
I verify that all information in this application is correct and complete.
I understand that there are risks to working on the Douglas-Hart Nature Center property. I will exercise reasonable safety precautions and will assume all liability for my own accidents and injuries while volunteering my time.
While volunteering, I will model good behaviors and language.
I will adhere by Douglas-Hart Nature Center rules and respectfully represent the facility and staff when on and off the site.
It is my responsibility to arrange my transportation. In the interest of helping DHNC, I will contact staff if I am going to be late or not coming.
E-signature of volunteer
E-signature of parent or guardian (if volunteer is under 18)
It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.
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