Jackson County Library Volunteer Application

Your Name:

Your Address:

Home Phone:

Work Phone:

Cell Phone:

Birthdate:

E-Mail Address:

Location Preference (check all that apply):

I am available:   All year Summer only Other   Specify dates if "Other" was selected:

Availability:

Education (check highest level):

Elementary High School Technical School Some College
College degree or professional training in:

Personal References (give two references from the local community, one of whom may be present employer):

What languages do you speak:

What languages do you read:

I understand that Jackson County may conduct a criminal background investigation, check my driving record, or contact my present or past employer references if necessary.

Yes No

Parental Permission:

If you are under 18, please have a parent/legal guardian sign a permission form at the orientation meeting.

Volunteer Skill/Interest Inventory

Indicate those areas for skill and for interest that pertain to you. Mark as many as applicable.

Orientation: All volunteers must attend orientation. Please contact: Carrie Prechtel, Community Outreach Specialist, at (541) 774-6407 or cprechtel@jcls.org.

Thank you for taking time to fill out this application!

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