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Volunteer Application
Thank you for your interest in volunteering with The L.E. Smoot Memorial Library. Please fill the Volunteer Application Form out completely and "Send Form" when you are finished. If you have an questions, please call the Library at: (540)-775-2147.
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* Indicates required question
Personal Information
First Name
*
Your answer
Last Name
*
Your answer
Address
*
Your answer
Apt.
Your answer
City
*
Your answer
State
*
Your answer
ZipCode
*
Your answer
Phone Number
*
Your answer
Email Address
*
(One that you check often.)
Your answer
Date of Birth
*
01/ 01/ 1985
MM
/
DD
/
YYYY
Occupation and/or Education
Highest Grade / College Degree(s) Completed
*
(Must be at least 12 years of age.)
Your answer
Are you a Student?
*
YES
NO
Current Employer / Name of School
*
Your answer
Parent/Guardian Consent
REQUIRED for volunteers under the age of 18.
I give permission for the above applicant to volunteer at the L.E. Smoot Memorial Library for a maximum of ____ hours per week.
1-5
5-10
10-15
15-20
Parent/Guardian Phone Number
(One you can be reached at easily.)
Your answer
Parent/Guardian Signature
Your answer
Reference Information
Please provide a personal or professional reference:
*
(Include Name, Phone Number and your Relationship.)
Your answer
This reference is:
*
Personal
Professional
Have you ever been convinced of a Crime that has not been Expunged or pardoned, other than a minor traffic violation?
*
YES
NO
If YES, When and for What offense?
A conviction will not necessarily hinder you from volunteering. This information will be used only for volunteer-related purposes and to the extent permitted by applicable law.
Your answer
Volunteer Interests
Have you ever volunteered at the L.E. Smoot Memorial Library?
*
YES
NO
I am seeking this volunteer position to:
*
(Please attach Court Order if necessary.)
become a regular library volunteer
satisfy school/class/scholarship community service requirements
satisfy a court-ordered community service requirement
Required
Please indicate the days you are available below:
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Required
What is the best time during those days for you to volunteer?
*
(Ex: 9 a.m. to 5 p.m.)
Your answer
Please indicate the MAX number of hours a week you are available:
*
1-5
5-10
10-15
15-20
Required
Why do you want to volunteer?
Your answer
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