Volunteer Application

Name

City, State, Zip Code

Street Address

Other Interests - Please Specify

Phone Number

Date of birth (dd/mm/yyyy)

Availability - What hours (and how many), specifically, are you available to volunteer?

Email Address

Interests - Please indicate in which areas you are most interested in volunteering your time. Interests - Please indicate in which areas you are most interested in volunteering your time. Assistance for youth events (set up, tear down, etc.) for summer reading Assistance with maintaining library collection ( weeding books, organizing, etc.) Creation of book displays, etc. Preparation for youth programs (crafts, etc.) Service of delivering materials to homebound patrons Service however needed Other

Availability cont'd Availability cont'd Monday Mornings Monday Afternoons Monday Evenings Tuesday Mornings Tuesday Afternoons Tuesday Evenings Wednesday Mornings Wednesday Afternoons Wednesday Evenings Thursday Mornings Thursday Afternoons Thursday Evenings Friday Mornings Friday Afternoons Saturday Mornings Saturday Afternoons

Special Skills & Qualifications - Please briefly list any skills and/or qualifications you have acquired from employment , previous volunteer work, or through other activities, including hobbies or sports.

Previous Volunteer Experience - Please briefly list any pervious volunteer experience you have.

Emergency Contact - Name

Street Address

City, State, Zip Code

Phone Number

Email Address

Agreement Agreement By submitting this application, I affirm that the facts set forth in it are true and complete. I understand if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. I also understand that the Rochester Public Library District, its staff members, and its patrons are not responsible for any injuries sustained during volunteer work.

Our Policy - It is our policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.