Fillable LANE COUNTY PARKS APPLICATION for NEW PARK HOST (Lane County)

Fill Online, Printable, Fillable, Blank LANE COUNTY PARKS APPLICATION for NEW PARK HOST (Lane County) Form

Use Fill to complete blank online LANE COUNTY (OR) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

LANE COUNTY PARKS APPLICATION for NEW PARK HOST (Lane County)

On average this form takes 47 minutes to complete

The LANE COUNTY PARKS APPLICATION for NEW PARK HOST (Lane County) form is 5 pages long and contains:

  • 2 signatures
  • 13 check-boxes
  • 172 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Lane County

BROWSE LANE COUNTY (OR) FORMS
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
LANE COUNTY PARKS
APPLICATION for NEW PARK HOST VOLUNTEERS
(Use this form for up to two volunteer applicants with the same mailing address. If at a different address attach a
separate application for each person. Include a separate resume if you wish.)
A
pplication for the _________ Calendar Year # of People Occupying Host Site _____
(Applicant 1) Last Name: _________________________ First Name: _____________________ Middle Initial: _________
(Applicant 2) Last Name: _________________________ First Name: _____________________ Middle Initial: _________
Full Name(s) of other people staying with you at host site: (Please indicate if these people are NOT planning to host)
____________________________________________________________________________________________________
Will you have a pet with you? Yes No Breed & Type: _________________________________________________
(We only allow up to 2 pets)
PART 1: Contact Info
PRIMARY Mailing Address: Include ALTERNATE Address Below if you wish:
Street:
Street:
City, ST, Zip:
City, ST, Zip:
Primary Phone #:
Primary Phone #:
2
nd
/Alternate Phone #:
2
nd
/Alternate Phone #:
Is this mail forwarding address only?
Yes No
If no, which month(s) can mail reach you here?
Which month(s) of the year can mail reach you here?
What’s the best way to contact you?
Primary E-Mail Address:
Secondary E-Mail Address:
P
ART 2: Job History/Skill Assessment (Applicant 1) Are you retired? Yes No
Previous Occupation (s): _____________________________ Current Occupation: _____________________________
P
lease list skills/duties or professional certifications that you obtained through occupation or volunteer time. As many as you
can please.
____________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Driver’s License STATE of Issue Only (do not include DL #):
_______________ Exp. Date: (mo/day/yr): _____________
P
ART 2: Job History/Skill Assessment (Applicant 2) Are you retired? Yes No
Previous Occupation (s): _____________________________ Current Occupation: ____________________________
Please list skills/duties or professional certifications that you obtained through occupation or volunteer time. As many as you
can please.
____________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Driver’s License STATE of Issue Only (do not include DL #):______________ Exp. Date: (mo/day/yr):________________
PART 3: Past Hosting Work
Have you been a host at other parks or recreation areas? Yes No If yes, please complete the info below. List most
recent experiences first and include all assignments during the last year you hosted. Attach 2nd sheet if you need more
room.
1) Park: ___________________________________________ State: _____ Public or Private
Host Type/Duties: _________________________________________________________________________________
Dates: _____________________________ Contact Name & Phone #: _______________________________________
2) Park: ___________________________________________ State: _____ Public or Private
Host Type/Duties: _________________________________________________________________________________
Dates: _____________________________ Contact Name & Phone #: _______________________________________
3) Park: ___________________________________________ State: _____ Public or Private
Host Type/Duties: _________________________________________________________________________________
Dates: _____________________________ Contact Name & Phone #: _______________________________________
4) Park: ___________________________________________ State: _____ Public or Private
Host Type/Duties: _________________________________________________________________________________
Dates: _____________________________ Contact Name & Phone #: _______________________________________
P
ART 4: My/Our Park Preferences, Dates of Availability & Park Assignments
Please fill in the years below to indicate the months you are available. Please mark with an X if you are available or
unavailable and use the notes section if needed. We encourage applicants to be available year round as our parks need year
round hosts.
January 20_____ Available ______ Not Available ______ Notes ___________________
February 20_____ Available ______ Not Available ______ Notes ___________________
March 20_____ Available ______ Not Available ______ Notes ___________________
April 20_____ Available ______ Not Available ______ Notes ___________________
May 20_____ Available ______ Not Available ______ Notes ___________________
June 20_____ Available ______ Not Available ______ Notes ___________________
July 20_____ Available ______ Not Available ______ Notes ___________________
August 20_____ Available ______ Not Available ______ Notes ___________________
Sept. 20_____ Available ______ Not Available ______ Notes ___________________
October 20_____ Available ______ Not Available ______ Notes ___________________
November 20_____ Available ______ Not Available ______ Notes ___________________
December 20_____ Available ______ Not Available ______ Notes ___________________
PART 5: My/Our References. List 2 references for each applicant, and include your relationship to them. Please list one
Personal and Professional reference.
Reference Name Address, City, State, Zip Phone Number Yrs Known?
Applicant 1:
Professional
Personal
Applicant 2:
Professional
Personal
P
ART 6: Questions. Please answer the following questions to help us determine the best placement for you.
Do you have any medical/physical conditions or limitations to be taken into consideration when assigning tasks?
*NOTE: All hosts do need to be physically able to perform the duties of the jobs they accept. Depending on your specific
hosting assignment, we may be able to modify the work to accommodate your needs.
Applicant 1: Yes No Please explain.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Applicant 2: Yes No Please explain.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Why do you want to be volunteer host?
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Is there anything else you’d like us to know about you?
____________________________________________________________________________________________________
____________________________________________________________________________________________________
How did you learn about LCP’s Park Host Program?
____________________________________________________________________________________________________
____________________________________________________________________________________________________
PART 7: Your Recreational Vehicle/ Camping Equipment
Most parks have host sites that can accommodate most size/length RV. However, parks reserve the right to place you in a
different site than planned.
Make/Year of RV: ______________________ Motorhome 5
th
Wheel Trailer Tent Other: _____________
Length of Entire Unit: (RV and/or Truck/Trailer) ______Is there an Extra or Tow Vehicle? Yes No Length: _______
Slide-Outs? Yes No Amps Needed: ______ Will you accept a site without full hook-ups? Yes No
Do you have a Satellite Dish? Yes No If yes, is it mounted on your RV or a separate portable one_______________
B
y Oregon law and as a safety precaution for visitors, staff, and other hosts, all hosts are subject to a criminal
background check each year before assigned duties can begin. Upon scheduling, we will request that you complete
a separate criminal history/DMV check form. Please read the statement below, fill in your name(s), then sign and
date the application.
I/We, ______________________________________ AND ___________________________________, hereby certify that
the information provided on this application is true and correct to the best of my knowledge and belief. I hereby grant Lane
County Parks (LCP), permission to verify facts contained here within. I hereby authorize the release of any relevant
information pertaining to reference checks, criminal history, driving records, education, work and volunteer history to verify my
eligibility to volunteer at any site operated by LCP. I agree to abide by LCP’s Volunteer Code of Conduct as provided.
1
st
Applicants Signature: _____________________________________________ Today’s Date: _________________
2
nd
Applicants Signature: _____________________________________________ Today’s Date: _________________
PLEASE SEND COMPLETED APPLICATION MATERIALS TO:
Lane County Parks
3050 N. Delta Hwy
Eugene, Oregon 97408
If emailing host app, email to:
laneparks@lanecountyor.gov
For more information call: 541-682-2000
Website: www.lanecounty.org/parks
click to sign
signature
click to edit
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

LANE COUNTY PARKS APPLICATION for NEW PARK HOST (Lane County)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 25 January 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document