Name__________________________________________Date of Application______________

Address_______________________________________________________________________

City________________________________State_____________________Zip______________

Telephone___________________________E-mail_____________________________________

I am interested in volunteering at the Dover Public Library.   I understand that I will not be an employee of the library, but I offer the following information on my background so that the library can place me in the most appropriate area.  I also give my permission for library staff to call any individual I have listed as a reference or employer.

Signature______________________________________________________________________

Highest Educational Level Attained:  (Circle)

Elementary/Middle School      High School       College

Employment/Address:___________________________________________

Years Employed___________

Supervisor:________________________       Telephone:________________

Volunteer Work: _______________________________________________________________

Contact/Reference_________________________________      Telephone:________________

I want to volunteer at the Dover Public Library because: _____________________________________________

______________________________________________________________________________

I would like to work in the following area(s) of the library: (Circle areas of interest)

Adopt-a-Shelf (shelf reading)     Assist with Programs      Children’s Services    Adult Services       Displays             Clerical

Other types of work I can do:   _______________________________________________

I have used a computer:  (Circle)     Yes      No

I have used:  (circle)   Word     Access       Excel     PowerPoint       HTML        Other_____________

I can volunteer the following days and times each week: (circle)    Monday     Tuesday

Wednesday Thursday     Friday    Saturday    Sunday

I can volunteer a total of   ______ hours each week.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Application taken by _____________Interviewed by _______________Date ___________

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