Frank Sarris Public Library

Frank Sarris Public Library

VOLUNTEER APPLICATION

In accordance with Pennsylvania law, all adults are required

to have applicable clearances to volunteer in the library.

Contact Information

Name ______Birthdate ______

Address ______

Phone Numbers – Please circle preferred number for us to call:

Home ______Work ______Cell ______

Email ______

Background Information

Educational Background ______

______

Work Experience ______

______

Previous Volunteer Experience ______

______

Skills and/or Special Interests/Hobbies ______

______

Availability

How many hours a week are you interested in volunteering? ______

Please indicate the days & times that you would be available for volunteering:

Monday 10-8 / Tuesday 10-8 / Wednesday 10-8 / Thursday 10-8 / Friday 10-5 / Saturday 10-5

Would you be willing to be a substitute or work on special projects as needed? YES NO

Is volunteering to be done for a community service requirement? YES NO

If yes, please explain the nature of your offense below: Service must be approved prior to volunteering and DUI cases will require a meeting with library board members to be approved.

______

References

Please list two references that we may call to inquire to your qualifications. High school students, please list a teacher or guidance counselor as one of your references.

Name ______Phone______

Name ______Phone ______

Consent for students (to be completed by Parent or Guardian):

My signature serves as consent for this applicant to serve as a volunteer at the Greater Canonsburg Public Library.

Signed ______Date ______

Confidentiality Statement

Volunteers will respect the privacy of all patrons, staff, and other volunteers and hold in confidence all personal information that may be disclosed during their time with the library. Volunteers will take necessary steps to protect the confidentiality of the patrons they encounter in their volunteer service, per the Pennsylvania Statutes and Consolidated Statutes Title 24.Education, Chapter 16.Libraries, Article IV P.S.§ 4428.

Applicant Signature ______Date ______

Interviewed by ______Date ______

Placement /Assignment ______Start Date ______

Additional Notes ______

______

Emergency Contact Information:

Name ______Relationship ______

Phone ______

VOLUNTEER CLEARANCES

All volunteers are required to have clearances before starting at the Frank Sarris Library. There are two clearances that are required of all volunteers – the PA child abuse history clearance and the PA State Police criminal record check. There is also a fingerprint check, but it is only required if you have not lived in PA continuously for the last 10 years. If you do not need the fingerprints, you will need to sign a Disclosure Statement with a library staff person as witness. Information on the clearances is as follows:

1. Information on the child abuse clearance can be found online at . Once you are on this page you can submit your clearances online or download a form to mail in your application. To submit an application online, it is necessary to create an account. The process for this will come up when you click the link to “Submit Your Clearance Online”. This is free for volunteers.

1. For a PA criminal record check, go to and click on “New Record Check (Volunteers Only)”. This is free for volunteers.

1. If you need to obtain a fingerprint background check, go to Click on the link for PA Department of Human Service that governs library work. Here you will register for the fingerprinting, but have to go to an authorized location to actually get the fingerprinting done. If you need more information while on this website, click the “Useful Link” for “First Time User? Click here”. Volunteers will have to pay a fee for fingerprinting if needed.

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