Volunteer Application Form

Privacy Policy

In respect to your privacy, all information submitted is confidential and is only used to comply with your request.

Name:

Date:

I am over 18 years of age:

Yes No

Birth Date (optional) (mm/dd)

Address:

City, State, Postal Code:

Telephone (Day):

Telephone (Evening):

Cell:

E-Mail:

In case of an emergency, contact:

Contact Name:

Contact Telephone:

Relationship:

Reference:

Reference Name:

Reference Telephone:

Reference Email:

Reference Type:

Work Personal

Employment Information

I am . . .

Currently Employed
Currently Not Working
Retired
Student

Employer (If Applicable):

Occupation:

Supervisor's Name :

Supervisor's Phone:

Student Information: Complete this section if you are currently a student.

Education (check most current)
High School: 9 10 11 12
College: 1 2 3 4
Graduate: 1 2 3 4

What School are you currently attending?

Will you receive school credit for volunteering and/or is this required for a course?

Yes No

If yes, please explain

Number of hours required for credit:

Volunteering

Why are you interested in volunteering?

Is this required community service? Yes No
If yes, please explain:

Number of hours required?

Do you have any previous Volunteer Experience? Yes No
If yes, please describe:

Please describe any interests or special skills you have that might help the library (foreign languages, computer skills, etc.) :

Are there any tasks that you would prefer not to be assigned to?

Availability

Please fill out the following chart with your available volunteer times:
Number of hours per week desired:

Day

Times

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Authorization

If under 18, you will need to bring proof with you stating that you have permission from your parent / guardian.

By clicking on the "Submit Application" button below, I agree to regard my assignment as a serious commitment and abide by the polices of Tompkins County Public Library. I also agree to maintain communication with my supervisor regarding my assignment and request clarification as necessary.

Note: If you experience difficulties applying online, please call: (607) 272-4557 ext. 226.
Page last modified Dec 14, 2012