NEW Zooteen Application "*" indicates required fields Step 1 of 4 25% Applicant InformationPlease provide contact information about the teen applicant here. Applicants are responsible for their own communications with zoo staff. Applicants should use their own phone and email, not their parent’s. There is space provided at the end of this application for parent contact information. Applicant's Name* First MI Last Applicant's Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Applicant's Cell Phone*Applicant's Email* Applicant's Date of Birth* MM slash DD slash YYYY Applicant's Age as of March 1 of this year* Applicants must be 14-18 years old as of March 1.RequirementsAre you willing and able to…* Attend a new ZooTeen training class (two Saturday morning sessions in March or April) Become a member of the Zoo (New ZT get a 25% discount, and a free membership after 60 hours of service in a year) Contribute a minimum of 40 hours in a year and at least 6 days at camp per summer Purchase a uniform nametag and t-shirt (approx. $25) Education & ExperienceSchool Class of:* List your extracurricular activities: Work ExperienceEmployer (present or prior) Dates of Employment Skills & InterestsHow did you find out about the Zooteen program? Why do you want to become a Zooteen? Describe your experiences in public speaking. Zooteens work with and talk to kids, families, and fellow Zooteens. Give us an idea of how comfortable and experienced you are speaking to others. Describe your experiences with animals. Describe your knowledge of and experience with animals, both domestic and exotic. How confident are you in handling and interpreting animals to others? What are your future goals, and how will volunteering at a zoo help you achieve them? Parent / Guardian InformationParent / Guardian Name First Last PhoneEmail Please note that most communications about trainings, scheduling, updates, etc. will go directly to the Zooteen. Zoo Membership # (if any) Name on Zoo Membership (if any) I understand that if accepted for a volunteer position, I agree to receive training to help me carry out my volunteer activities. I affirm under the penalties for perjury that I have never been arrested or convicted for any offense against children. I understand that my name will be checked out through the Indiana Child Safe program. I further affirm under the penalties for perjury that I have never been arrested or convicted for any offense against animal welfare. I certify that all information provided on this application is true and complete. I understand that falsification or significant omissions of any information may be considered justification for non-acceptance or dismissal if discovered at a later date. I give permission to be listed on the ZooTeen Phone List to be distributed to fellow ZooTeens.Applicant Signature*Date* MM slash DD slash YYYY Parent / Guardian SignatureDate MM slash DD slash YYYY CAPTCHANumberNumberNumberNumberPhoneThis field is for validation purposes and should be left unchanged.