Full Name: Preferred Name

Full Name: Preferred Name

Application for Library Volunteer

PLEASE PRINT

Full Name: Preferred Name:

Address: City: State: Zip:

Home Phone: Cell Phone:

E-mail: Birth Date: / /

(must be over 18 years old)

Volunteer positions require a background check. Are you willing to do this? Yes ______No______

Have you ever been employed by the district? Yes______No______If yes, dates:______

AVAILABILITY

Day(s) & hours I canvolunteer (Ex: Mon 2-5pm, Thur 9-11am)

Sun Mon Tues Wed Thur Fri Sat

VOLUNTEER LOCATION

The St. Charles City-County Library District has twelve branch locations and one General Administration Office. Please indicate which location you would prefer:

1st request 2nd request 3rd request ______

kl – kathryn linnemann branch mk – middendorf kredell branchsp – spencer road branch

my – mcclay road branchkr – kisker road branchcp – corporate parkway branch

dr – deer run branchwh – winghaven branchde – discovery village branch

nc – north county branchsc – south county branchbt – boone’s trail branch

ga – general administration

COMMUNITY SERVICE

I am fulfilling community service requirements for:  School  Scouts  Church ______

Total hours needed to fulfill requirement: Date hours must be completed: / /

Please attach the requirements for your community service.

INTERESTS

The St. Charles City-County Library District has a variety of volunteer opportunities for a wide range of skills and abilities. Some of the positions and tasks that may be assigned to volunteers are listed below. Please check 3 areas in which you may be interested in assisting:

 General Library Volunteer

  • Organizing magazines and periodicals
  • Straightening, organizing and cleaning within the library
  • Materials preparation (cutting, stamping, etc)
  • Preparing mailings
  • Create library displays
  • Assist in planning and/or working at special events
  • Summer Reading program registrations

 Ready to Read Volunteer

 Mini-Library Manager

 Books to You Book Discussion Leader

 Books to You Home Visit Specialist

Please check any of the skills, abilities or interests below that are applicable to you:

  • Previous library work (Location: ______)
  • Foreign language skills (List languages: ______)
  • Special events (type of event/responsibilities: ______)
  • Marketing, writing, promotions (type of experience: ______)
  • Art skills, graphic design, other: ______)
  • Experience leading book discussions
  • Data processing/computer work

Other:______

AGREEMENT AND SIGNATURE

I hereby certify that the information on the above application is true and complete. My signature authorizes the St. Charles City-County Library District to verify any of the information on this application and to complete a criminal background check. I understand that information contained on my application will be verified and that misrepresentations or omissions may be cause for my immediate rejection as an applicant or my termination as a volunteer.

Applicant Signature: Date: / /

OFFICE USE ONLY

Worker Reg Background

Date App Rec’d: Sent to HR: Check Cleared:

Vol Location: Start Date: updated 9/10/13

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