VOLUNTEER APPLICATION FORM – Home Library Service Date: …………………

Thank you for expressing interest in applying for a Home Library Service volunteer role with the Geelong Regional Library Corporation (GRLC). Could you please complete sections 1, 2, 3 & 4 of this form to Express Your Interest in a role and NOTE other sections of this form will be completed if you are successful in obtaining a volunteering position.

  1. Personal Details

Title: / Surname: / First Name/s:
Preferred Name:
Address:
Suburb: / Post Code:
Postal Address (if different to the above):
Suburb: / Post Code:
Daytime Phone: / Mobile Phone:
Email: / Date of Birth
(for insurance purposes only):
  1. Areas of Interest

Volunteer role (s) you are interested in? Please tick if you are interested in other areas as well as Heritage.
X Home Library Service Volunteer
□ Word for Word Festival Volunteer (yearly event)
□ Community Library Service Volunteer
□ Other………………………………………………
Why are you interested in volunteering for the GRLC Home Library Service?
What skills and/or experience can you bring to this role? (Please attach additional details and/or relevant information):
Do you speak, read or write a language other than English? If so, please list:
Do you currently comprehensive Car Insurance? Yes / No
Licence No……………………………………………………… Licence Expiry……………………………………
  1. Availability – For Current or Future Volunteering

Please tick which days of the week, frequency and times you are available: (Note: Home Library Service Deliveries happen between the hours of 9am – 6pm Monday to Saturday)
Frequency: / Weekly / Fortnightly / Monthly / Other (please specify):
Monday / Tuesday / Wednesday / Thursday / Friday / Saturday / Sunday
Morning / -
Afternoon / -
  1. Supporting Documents and Checks

A Volunteer Police Check and Volunteer Working with Children Check are required to become a GRLC volunteer. Please complete information below. If you have these documents or obtain them for a volunteer role at the GRLC you will be required to provide copies for your file.
Do you have a Volunteer Working with Children Check? Yes / No
Do you have any objection to undertake a Volunteer Working with Children Check? Yes / No/ NA
Do you currently have a Volunteer Police Check? Yes / No
Do you have any objection to undertake a Volunteer Police Check? Yes / No/ NA
  1. Ability to Volunteer

Do you have any impairment or condition that could be aggravated by doing the tasks listed in the Role Description? Yes / No (please circle)
Details:
  1. Volunteer Agreement

I have read and I understand the contents of the GRLC Volunteer Handbook, including my rights and responsibilities as a GRLC volunteer. I am willing to abide by GRLCs’ policies and guidelines, and commit to the requirements of the role as described in the role description.
Volunteer Name:
Signature: Date
Volunteer Supervisor Name :
Volunteer Supervisor Signature: Date
  1. Emergency Contact Details

In case of an emergency it is essential that all volunteers list an emergency contact.
Name: / Relationship:
Address:
Daytime Phone: / Mobile Phone:
  1. References

Please provide contact details for one reference.
Referee: Relationship to Applicant:
Contact Phone number:
1 / HP