"*" indicates required fields EmailThis field is for validation purposes and should be left unchanged.Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Phone*Email* Emergency Contact Name* First Last Emergency Contact Phone*Are you a Junior Volunteer (Age 14-17)* Yes No Parent/Legal Guardian Name* First Last Parent/Legal Guardian Phone (if different from above)Parent/Legal Guardian Email (if different from above) Name of School*Age*Please enter a number from 14 to 17.Applying for Service Hours? Yes No How many do you need this year?Do you have any physical, mental or sensory limitations which might affect your work performance or which should be considered in job placement?* Yes No Please explain*Have you been convicted of a criminal offense in the last 7 years?* Yes No Please provide details, which will be kept in strictest confidence:*How did you hear about BUEI? Advertisement Website Friend BUEI employee Volunteer Other Please specifyWhy do you want to volunteer with us? What do you hope to gain from being a volunteer at BUEI?*Availible Days*Select All That Apply Weekdays Weekends Available Times*Select All That Apply Mornings Afternoons Evenings Interests, Hobbies & Special Skills Research Video/Photography Donor Engagement Marketing/Communications Fundraising/Events Retail Sales/Cashier Museum Tour Guide Education Support/Camp Assistant BUEI Mascot Please indicate other skills you would like to use while volunteeringCertification* I CERTIFY THAT THE INFORMATION CONTAINED IN THIS APPLICATION FORM IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT MISREPRESENTATION OR OMISSION OF FACTS HEREIN IS CAUSE FOR TERMINATION OF SERVICE. I ALSO AGREE THAT, AS A CONDITION OF BEING SELECTED, I MAY BE SUBJECT TO A BERMUDA POLICE CRIMINAL RECORD CHECK.*VOLUNTEER LIABILITY RELEASE* I acknowledge and fully understand that I and/or the minor participant will be engaging in activities that involve risk. As a Volunteer, I accept the risks attendant upon activities that I undertake and agree that the Bermuda Underwater Exploration Institute (BUEI) has no responsibility for loss or damage to personal possessions, or bodily injury sustained in the course of acting as a Volunteer. I hereby acknowledge that I have read the above statements and fully understand them.*Photo Release* I consent to and authorize the use and reproduction of any photographic and/or video material taken of me may be used for training purposes or publicity.*Privacy* I have read and agree with the Privacy Notice*Name of Parent/Guardian* First Last Name of Parent/Guardian* I acknowledge and fully understand that I and/or the minor participant will be engaging in activities that involve risk. As a Volunteer, I accept the risks attendant upon activities that I undertake and agree that the Bermuda Underwater Exploration Institute (BUEI) has no responsibility for loss or damage to personal possessions, or bodily injury sustained in the course of acting as a Volunteer. I hereby acknowledge that I have read the above statements and fully understand them.* Leave this field empty
