Grinnell Library
2642 East Main Street, Wappingers Falls, New York 12590
Phone: (845) 297-3428 Fax: (845) 297-1506
http://Grinnell-Library.org
Application Form for Youth Library Volunteers
(under age 18)
Your name _______________________________________________________
Your age _____________ School name _______________________________
Parent’s name ____________________________________________________
Address _________________________________________________________
Phone (Home)_________________(Parent’s work phone)__________________ Cell phone _____________
Emergency contact (if different from parent):
Name ____________________________ Relationship____________________
Phone _______________________
Your E-mail ______________________________________________________
When can you volunteer? ___________________________________________
Days/times you are available to volunteer: (Mark as many as you wish.)
Monday □ am □ pm Tuesday □ am □ pm Wednesday □am □ pm
Thursday □ am □ pm Friday □ am □ pm Saturday □ am □pm
Sunday □ am □ pm
I am good at: Reason(s) for Volunteering:
□ Computers □ School Credit
□ Arts and crafts □ Judicial
□ Photography □ Honors Society
□ Working with children □ Other_______________________
□ Helping people find things in the library
□ Other _____________________
____________________________ ________________________
Volunteer’s signature Date
Parents: Please read and sign below:
I give permission for my son/daughter to volunteer at the (insert your library name) library. I understand that my child should be picked up promptly (if necessary) when his/her volunteer time is over and that he/she will be expected to dress appropriately for work in a public place.
_____________________________ _____________________
Parent’s signature Date
2642 East Main Street, Wappingers Falls, New York 12590
Phone: (845) 297-3428 Fax: (845) 297-1506
http://Grinnell-Library.org
Application Form for Youth Library Volunteers
(under age 18)
Your name _______________________________________________________
Your age _____________ School name _______________________________
Parent’s name ____________________________________________________
Address _________________________________________________________
Phone (Home)_________________(Parent’s work phone)__________________ Cell phone _____________
Emergency contact (if different from parent):
Name ____________________________ Relationship____________________
Phone _______________________
Your E-mail ______________________________________________________
When can you volunteer? ___________________________________________
Days/times you are available to volunteer: (Mark as many as you wish.)
Monday □ am □ pm Tuesday □ am □ pm Wednesday □am □ pm
Thursday □ am □ pm Friday □ am □ pm Saturday □ am □pm
Sunday □ am □ pm
I am good at: Reason(s) for Volunteering:
□ Computers □ School Credit
□ Arts and crafts □ Judicial
□ Photography □ Honors Society
□ Working with children □ Other_______________________
□ Helping people find things in the library
□ Other _____________________
____________________________ ________________________
Volunteer’s signature Date
Parents: Please read and sign below:
I give permission for my son/daughter to volunteer at the (insert your library name) library. I understand that my child should be picked up promptly (if necessary) when his/her volunteer time is over and that he/she will be expected to dress appropriately for work in a public place.
_____________________________ _____________________
Parent’s signature Date
