Forms • Chelsea, AL • CivicEngage

First and Last Name*

Address *

Phone Number*

Email Address*

Parent/Guardian name.*

School and Grade*

Age

What day(s) can you volunteer? Check all that apply.*

	Monday
	Tuesday
	Wednesday

	Thursday
	Friday
	Saturday

What time(s) can you volunteer? Check all that apply.*

	Morning (9:15-12:15)
	Afternoon (12:30-3:30)

Evening (3:45-6:45)

T-Shirt Size*

When are you wanting to volunteer? Check all that apply.
*Please note, selected choice does not guarantee being scheduled for that time slot.*

	Summer (June-July)
	Summer Wednesday Program 1:30-3:30s

	Summer Tot Time Party (July 29 & 30 10:00-12:00)
	Year Round

Reason for volunteering.

*Please note: Court ordered community service must first be approved by library board.*

	Voluntary
	School

	Scholarship
	Court Ordered*

How many hours are needed?

Do you have any library experience? Whether as a volunteer or paid employee.*

Yes

No

Are you able to perform light physical duties?*

Yes

No

If "No", please explain.

What is your comfort level working with computers?*

	1 - Never used a computer
	2
	3

	4
	5 - Expert

Are you comfortable working with children?*

Yes

No

Please list any skills or talents you would be willing use while volunteering at the library.*

How do you use your local library?*

Please provide a reference contact(s). Include name, occupation, and contact information.

Emergency Contact*

Relationship*

Phone Number*

I understand that I represent Chelsea Public Library while I am at work as a volunteer. I understand that volunteers are directly supervise by staff and are to follow all staff directions. I understand that library volunteers are used as needed and that I will be required to remain inside the library at all times while serving as a volunteer.

Student and Adult Signature *

I understand that my child will act as a library volunteer on a part-time basis as needed. I understand that it is my responsibility to provide transportation to and from the library unless the library director is informed otherwise. I understand that the library staff will supervise volunteers but will not be responsible for the safety or behavior of my child.

Parent or Legal Guardian signature *

* indicates required fields.

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