2009-06-30T11:44:00.001-07:00

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