Date:
Name:
Mailing Address:

City:		State:		Zip Code:
Phone: (home):		(work)		(email)

School and grade you're in:

Employment and/or volunteer experience:

Skills/Interests:

Special Projects	Working w/children:
Photocopying:	Shelf videos/audios
Answering Phones	Book Sales

At which location would you prefer working? Please select one. Main Indian Creek Branch Either

Please list the most convenient times you can volunteer (same time every week). There are two hour shifts available after school/evenings during the week and on Saturdays and Sundays, as well.

Emergency Contact

Name:
Phone:

Thank you for your interest. You will be contacted for an interview when a position that matches your skills, interests, and schedule becomes available.