Date Name First Name Last Name Address Address City/Town State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon ZIP/Postal Code Phone Number Email Address Date of Birth: (Must be 14 years of age to volunteer) School and Grade (if applicable) For hourly requirements, how many hours do you need? Date Due: Availability: (Include times each day, example 1-2pm)*Shifts are a minimum of 2 hours/week. Availability Monday Tuesday Wednesday Thursday Friday Saturday Volunteer Interests: (Please check all areas of interest) Shelving, Sorting, and Shelf Reading (Making sure books are in order) Program Assistance Craft Preparation General Maintenance Summer Reading Program Clerical Special Projects Distributing Fliers Friends of the Library Fundraising Why do you want to volunteer at the Mulvane Public Library? What do you hope to gain from this experience? References: (Please list two references who are not relatives) 1. First Name Last Name Email Phone How do you know this person? 2. First Name Last Name Email Phone How do you know this person? Emergency Information:In case of an emergency, contact: (Name, phone, and relationship to volunteer) Emergency Contact Info First Name Last Name Relationship to Volunteer Date I understand that this is an application for, and not a commitment to or promise of, a volunteer opportunity. I certify that all information provided is true, correct, and complete to the best of my knowledge. I have not and will not withhold any information that would unfavorably affect my application for a volunteer position. If 18 years of age or older, I understand that the Mulvane Public Library may verify information contained on my application in a background check. I also understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant or my termination as a volunteer. I authorize investigation and/or verification of all statements contained in this application and release all parties contacted from any and all liability resulting from information provided. If you are under 18, please have a parent or guardian check the box below as well: I give permission for the applicant to volunteer at the Mulvane Public Library.