Volunteer Form

2023 PA Envirothon Volunteer Form

First Name(Required)

Last Name(Required)

Email Address(Required)

Phone(Required)

Agency(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Volunteer Gender(Required)

Female

Male

Prefer to Self Identify

Volunteer T-Shirt Size(Required)

Small

Medium

Large

X-Large

XX-Large

XXX-Large

Dietary Selection(Required)

Regular Meals

Vegetarian Meals

Other

Dietary Restriction / Food Allergy

Emergency Contact Name(Required)

Emergency Contact Phone Number(Required)

May 17th- Indiana County Conservation District May 18th- Snyder County Conservation District May 19th- Monroe County Conservation District Volunteers must arrive by 9:30 for volunteer orientation.

2023 Oral Presentation Volunteer Dates(Required)

Please select which volunteer assignments you would be willing to assist with during oral presentations. You may select more than one. * Please understand that every effort will be made to assign you to a volunteer duty you selected, however this can not be guaranteed.(Required)

The 2023 Pennsylvania Envirothon on May 24, 2023

Please select which volunteer assignments you would be willing to assist with at station testing on May 24, 2023. Please understand that every effort will be made to assign you to a volunteer duty you selected, however this cannot be guaranteed.(Required)

Station Travel Official

Food Service Volunteer

Station Judge

Station Test Scorer

I am unable to volunteer for field testing.

Volunteer Verification

Volunteer clearances -child abuse and state police background check must be uploaded or submitted by email to: paenvirothon1@gmail.com.(Required)

I want to upload clearances now

I will email clearances to paenvirothon1@gmail.com

File

Max. file size: 2 GB.

File

Max. file size: 2 GB.

I hereby grant permission to PA Envirothon to use names, photographs, and/or videos of myself that are produced during the 2023 PA Envirothon State Competition in publications, news releases, online, social media, and in other communications related to the mission of PA Envirothon.(Required)

Yes, I give permission.

No, I do not give permission.

Questions about volunteer registration can be directed to Courtney Raker or Jason Winey at 570-837-3000 or by email paevirothon1@gmail.com

Volunteer Signature (Print Name)(Required)

Today's Date(Required)

MM slash DD slash YYYY

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