Application for Teen Volunteers

* = required field

* Name:

* Address:

* City:

* State:

*Zip

* Phone:

email:

* Name of Emergency Contact:

* Emergency Contact Phone:

* Relationship to you of Emergency Contact:

* School:

* Grade:

* Name of Reference:

* Phone number of Reference:

Check this box and complete the following information if you are volunteering to complete requirements for community service (for example, school graduation requirements, National Honor Society, etc.)
** = If this box is checked the following are required.

** Name of
Organization:

** Address:

** Completion
Due Date:

** Hours Required:

Please fill in the bottom row of this chart with the days and times you would regularly be available to volunteer at the Library. * At least one box below is required.

Day of the Week	Monday	Tuesday	Wednesday	Thursday	Friday
Library's Hours:	9:30 am - 8 pm	9:30 am - 5 pm	9:30 am - 8 pm	9:30 am - 8 pm	9:30 am. - 5 pm
Your Availability:

Please type in the number of hours you wish to work per week:

Have you volunteered at the library before? Yes

* Would you be interested in serving on our Teen Advisory Board? Board service counts as community service. Yes No

Tell us about any previous volunteer experience, your hobbies and interests, and any foreign language ability:

The applicant and a parent or guardian must come to the library to sign the application before work begins.

Please note that Library volunteers are not covered under the Town's Workers' Compensation policy because they do not meet the definition of employees of the Town.

I, __________________, Parent/Guardian, understand that my child is not covered by a Workers' Compensation policy while volunteering at the Bethel Public Library and that he/she must attend a one-hour orientation session before beginning any regular volunteer hours.

Applicant's Parent/Guardian Signature: __________________________

Date: ___________________

Applicant's Signature: __________________________

Date: ___________________

The Bethel Public Library reserves the right to limit the number of active volunteers at any one time because of the need for staff supervision and training.

For library use only:
Date application received:

Date applicant contacted:

Agreed-upon schedule:

First day:

Last day:

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This page last updated 7/13/07