Volunteer Application Form

Privacy Policy

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

If you have trouble with the webform, please contact the Volunteer Coordinator and include as much of the followinginformation as you can in your email, volunteercoordinator@tcpl.org. Thank you.

If yes to either question, please use space below to give full explanation, and indicate when hours need to be completed.

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

Have you ever been convicted of a crime (felony or misdemeanor)?

Yes No

Is this court-mandated volunteer service (city, town or county-court, or school (e.g. JA)-mandated)?

Yes No

If yes, please explain

A yes answer will not necessarily disqualify you. Each case is evaluated on an individual basis in relation to the duties and responsibilities of the volunteer positon for which you have applied. You may omit parking violations. We will conduct a background check with the Sex offender Registry for those volunteers working with children.


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?

How did you hear about volunteering at the Library?


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 am agreeing to the following:

I understand that the TCPL Library has the right to evaluate all applicants and will not accept a volunteer that would jeopardize the materials and services of the library or the safety of the library staff and patrons.

I understand that I am a volunteer and that there is no compensation for volunteer services at TCPL by TCPL.

I understand that as a TCPL Library volunteer I may come in contact with confidential information. I agree to protect this information in compliance with the New York State Civil Practice Law and Rules 4509 and will not divulge any information during or after my services as a volunteer.

I agree to abide by all library policies and understand that as a library volunteer I am representing the TCPL library and must portray a positive image at all times.

I consent for the TCPL Library to conduct thorough research on my background which may include a formal background check through the Tompkins County Sheriff’s Department.

I certify that all statements made on this application are true.

Note: If you experience difficulties applying online, please call: (607) 272-4557 ext. 226.

Page last modified Oct 7, 2014