Volunteering: ApplyPrint / Download Application Form Volunteer Application Personal InformationName* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone* Email* References Name First Last Years knownPhoneEmail Relationship Best method of contact Phone Email Add ReferenceRemove ReferenceHave you ever been convicted of a felony?* Yes No If yes, please describe.Please list any health issues that you have that could affect your volunteer work:*Please list your computer skills:*How often would you like to volunteer?* On a regular basis For special events only If you checked on a regular basis, how regularly? Once a week Twice a week Twice a month Other Other: Task/Role Interest and ExperienceFor each task/role, please indicate whether or not you have experience with or interest in.Genealogy Interest Experience Office Tasks Interest Experience Children's Programs Interest Experience Organizing Events Interest Experience Shelving Interest Experience Graphic Design Interest Experience Publicity Interest Experience Reading Aloud Interest Experience Tutoring Interest Experience Processing New Books Interest Experience Decorating Interest Experience Data Analysis Interest Experience Fundraising Interest Experience Statement of Confidentiality*Library patron information is considered confidential. Information pertaining directly or indirectly to any staff member, patron, or another volunteer shall not be repeated or discussed inside or outside the library. I agree to the Statement of Confidentiality.Volunteer Waiver of Liability*Iunderstand that I will not be covered by Worker’s Compensation. If I use my own car while performing volunteer duties, I am responsible for my own insurance. By signing this application, I release the Centerville Center Township Public Library from any liability with respect to any personal injury, illness, death, or property damage that may result from my volunteer activities. I agree to the Volunteer Waiver of Liability.Volunteer Compensation Understanding*I understand that I will not be paid for my services as a volunteer, and I expect no compensation. I agree to the Volunteer Compensation UnderstandingSignature* Please type your full name.Date Signed* Parent or Guardian's Signature(Required if Applicant is under age 18) Date Signed by Parent or Guardian Print / Download Application Form