2015 Spring Basic Training Application

UPDATE: Due to a lack of applicants we are unable to hold the Spring 2015 basic training. Thank you to those who showed interest, we hope we can fill minimum for a class next time!


Virginia Master Naturalist Program - Blue Ridge Foothills and Lakes Chapter

Spring 2015

To Potential Applicant:

Thank you for your interest in applying to be a Virginia Master Naturalist through the Blue Ridge Foothills and Lakes Chapter (BRFAL) training program.  Plans are underway to offer the training program beginning on Wednesday, March 4, 2015, in Rocky Mount, Virginia.

The BRFAL training program is designed to prepare individuals as Certified Virginia Master Naturalists for the statewide corps of master naturalist volunteers carrying out the Virginia Master Naturalist Program mission of “providing education, outreach and service dedicated to the beneficial management of natural resources and natural areas within their communities”.  As such, it will provide the background knowledge and opportunity for skill development necessary to be effective as a volunteer Certified Virginia Master Naturalist.

To become a Certified Virginia Master Naturalist, a trainee must:

·        Complete 40 hours of basic training, which includes a minimum of 25% time in the field;

·        Pass the open-book training assessment with a score of 70% or higher;

·        Complete 8 hours of approved advanced training designed to focus volunteer efforts on one or more specific topics of interest; and

·        Complete a minimum of 40 hours of service in a BRFAL approved project within 12 months of the completion of the basic training program.

To maintain certification, each Virginia Master Naturalist must complete an additional 8 hours of advanced training and 40 hours of service annually.

BRFAL’s training sessions will be held on Wednesday evenings from 6:00pm to 9:00 pm, beginning  March 4, 2015  and finishing May 6, 2015, in The Franklin Center in Rocky Mount (behind the Franklin County Library).  There will also be some Saturday sessions for field trips.  The location of Saturday field sessions will vary based on the topic being presented.  Trainees may not miss more than 2 classes, and all missed sessions must be made up by attending the appropriate class(es) within 12 months of the completion of training. 

The cost of the program, including materials, is $125.  This fee also entitles each participant to a one-year membership in the BRFAL Chapter of the Virginia Master Naturalist Program. Registration opens up to applicants on January 5, 2015. Because of limited seating, the deadline for submitting applications is February 16, 2015.  The BRFAL Application Committee will notify all applicants of the status of their application.  Applicants accepted for the training program must send a check for $125 (payable to BRFAL) to be received at the address below not later than February 25, 2015, one week before the beginning of the class.  A minimum of 10 students is required to hold these training classes; enrollment by fewer than 10 will likely result in the class being cancelled and monies refunded.

If you wish to apply for the Spring 2015 basic training program, please complete and mail the attached application form  (along with the course fee of $125 if you choose to do so at this time) to:

Virginia Master Naturalists

Blue Ridge Foothills and Lakes Chapter

P.O. Box 42

Wirtz, VA 24184

ATTN:  Application Committee

BRFAL generally holds monthly meetings on the 3^rd Thursday of each month at 7:00 pm.  The meeting place alternates between Rocky Mount (in the Franklin Center), and the Westlake area of Smith Mountain Lake (in the Smith Mountain Lake Association office on Scruggs Road, in Moneta).  In general, in even months the meetings are held in Westlake and in odd months in Rocky Mount.  Please feel free, if you are interested in joining the program, to attend any of these meetings.  We try to have guest speakers throughout the year and you are certainly welcome to these meetings, as well as our regular business meetings.

For other questions about the Virginia Master Naturalist Program and/or BRFAL Chapter, please call (540) 365-4613.

APPLICATION BELOW

                                                                    

Virginia Master Naturalist Program

Blue Ridge Foothills and Lakes Chapter

Volunteer Information and Enrollment Form

2015 Application

A.  GENERAL INFORMATION (please print)

Name:          ______________________________________________________________________

               (Last, First, MI)

Mailing Address: _____________________________________________________________________

                               (Street, Box, Route, Apt #)

              ______________________________________________________________________

                             (City, State, Zip)

 

County or Independent City of Residence: ______________________________________                             

B.  CONTACT INFORMATION

Phone (please indicate which phone number is preferred):

            Home   ______________________                         Cell  ______________________                

Work     ______________________

E-mail: ______________________________________________________________________________

 

Emergency Contact:  Name ______________________________________________________________

Phone:  ___________________________________ Day  _______________________________ Evening

C. VOLUNTEER INFORMATION

1.  Certification as a Master Naturalist requires 40 hrs. of volunteer service. Below are some of the ways those hours may be obtained. Please indicate your interests below (we realize your ideas may change).

                         

1. Are you interested in education/outreach opportunities?    Yes     Maybe     No     No Idea

(eg. classroom presentations, staffing a booth, nature walks)

2. Are you interested in Citizen Science opportunities?          Yes     Maybe    No      No Idea

(eg. Stream monitoring, wildlife mapping, hawk watch, bird counts)

3. Are you interested in stewardship opportunities?                Yes     Maybe   No       No Idea

(eg. Trail building, stream cleanups, native plant rescues, invasive plant removal, and habitat restoration)       

2.  When are you available to volunteer and participate in VMN activities? (seasons of the year, days of the week, time of day)

3. Tell us about your previous volunteer experience (use back if necessary).

4. Do you have a particular topic that you are interested in or knowledgeable about, and/or do you have experience or education in a natural science or environmental field?

5. Do you have any hobbies related to master naturalist subjects, e.g., birding, hiking, mushroom hunting, butterfly watching, etc.?

6. How did you find out about Virginia Master Naturalist program? Do you know any master naturalists?

The following information is required for all Virginia Master Naturalist State Program volunteers.

4.  DEMOGRAPHIC INFORMATION (Optional, for record keeping purposes only)

Gender:   (  ) Female                                      

               (  )  Male                                Date of Birth: ________________________________

Race:                                                                    (must be 18 or accompanied by an adult if 14-17)

     (  )  White                              (  )  Hispanic          

     (  )  African American             (  )  Asian                         

     (  )  American Indian               (  )  Multi-Racial                          

                                                                     

5.  REFERENCES (no family members)

1.         Name:_______________________________   Relationship____________________________

Phone (Day)__________________________   (Evening)______________________________

2.         Name:_______________________________   Relationship____________________________

Phone (Day)__________________________   (Evening)______________________________

 

3.         Name:_______________________________   Relationship____________________________

Phone (Day)__________________________   (Evening)_______________________________

 

F. DRIVING INFORMATION

                                                                                          Yes              No

Do you have a current and valid driver’s license?                  □                  □

If yes, issued in the state of _________________

Do you have a current commercial driver’s license (CDL)?     □                  □

Do you currently have the minimum vehicle insurance

coverage as required by the Commonwealth of Virginia?       □                  □

 

G.  BACKGROUND INFORMATION

(This information is required by the State Master Naturalist Program and will be kept in a confidential manner and accessible only to authorized personnel.  A “yes” answer does not automatically exclude you from becoming a registered volunteer.)

Have you ever had any criminal convictions related to:

Yes              No

a. alcohol or drug abuse?           □                  □

b. child abuse or neglect?           □                  □

c. spousal abuse?                       □                  □

d. elder abuse or neglect?           □                  □

 

Have you ever been convicted

of any violation(s) of law?                           □                  □

 

If volunteering for a position that

requires the operation of a vehicle, have you

been convicted of any moving traffic

violations within the last 5 years?           □                  □

If “yes” to any of the above, please describe.

 ___________________________________________________________________________

I understand that records and criminal background or reference checks may be conducted on me at any time during the application process or during volunteer service for the Virginia Master Naturalist Program.

____________________________________________                 ____________________________________

Signature, Volunteer                                                                             Date

H.  VOLUNTEER AGREEMENT

I understand that I am a volunteer for the Virginia Master Naturalist Program and will receive no financial compensation or benefits for assistance rendered in any capacity.

I agree to abide by all policies and procedures of the Virginia Master Naturalist Program and its sponsoring agencies.

I understand that I am responsible for my personal injuries and illness while participating in this program, and that I will hold the program and all joint and sponsoring agencies harmless.  I understand that my chapter adviser may file a claim for my injuries with the Virginia Division of Risk Management.  If accepted, I understand that I or my insurance company may be fully or partially reimbursed.  I understand that a claim filed with the Virginia Division of Risk Management does not guarantee acceptance or reimbursement.

I understand that the Virginia Master Naturalist Program is open to all, regardless of race, color, national origin, sex, religion, age, disability, political beliefs, sexual orientation, or marital and family status.

_____________________________________  _____________________

                    Signature, Volunteer                              Date

_____________________________________  _____________________            __________

                    Signature, Chapter Advisor                    Agency                                       Date

_____________________________________________

I.  MEDIA RELEASE

Virginia Cooperative Extension and the Virginia Master Naturalist Program periodically use photographs or video or audio footage or testimonials of program participants for local, regional, or state publicity or educational purposes.  By my signature on this Volunteer Information form, I acknowledge receipt of this document and give permission for Virginia Cooperative Extension and the Virginia Master Naturalist Program to use such reproductions for educational and publicity purposes.

                             

___________________________________________   

________________________________________                           ___________________

                        Signature, Volunteer                                                   Date

Please print and complete this form, sign it in the 3 indicated fields, and return it to:

Virginia Master Naturalist

Blue Ridge Foothills and Lakes Chapter

P.O. Box 42

Wirtz, VA 24184

ATTN:  Application Committee

The Virginia Master Naturalist Program is sponsored jointly by Virginia Cooperative Extension, the Virginia Department of Conservation and Recreation, the Virginia Department of Forestry, the Virginia Department of Game and Inland Fisheries, and the Virginia Museum of Natural History.