Volunteer Application - Dearborn Public Library (Page 4 of 4) in pdf

Volunteer Application - Dearborn Public Library Page 4

Volunteer Orientation Video: I have viewed the Volunteer Orientation DVD or video

link from the Dearborn Public Library Homepage and accept the policies and

provisions set forth in the volunteer orientation presentation. Check the appropriate

box below.



I accept

I decline

VOLUNTEER AGREEMENT (Agreement is not finalized until signature is present)

My signature certifies that the information provided above is accurate and authorizes

the Dearborn Public Library to verify any of the information and secure information

from personal references. I understand that as a volunteer I am not entitled to

monetary compensation for the work that I perform or be entitled to worker’s

compensation or group benefits in the event of injury. The Dearborn Public Library

reserves the right to evaluate volunteer performance and the right to terminate

services should responsibilities not be fulfilled satisfactorily.

Date ___________________

Print Name _______________________________________________________

Signature ________________________________________________________

Signature of parent or guardian _______________________________________

(Required if applicant is under age 18)

Print Name of Parent/Guardian__________________________________________

For Dearborn School Community Service

Print Counselor’s Name ______________________________________________

Counselor’s Phone Number _____________________________

Signature of Counselor ______________________________________________

Date ________________________

The Dearborn Public Library cannot accommodate all volunteer requests. Volunteer

opportunities are available on a limited basis.

After you submit your application, please allow 3 weeks for processing. You will be

contacted by a volunteer coordinator. Please make sure you contact information is

legible.

Court ordered community service volunteers cannot be accepted.

Revised 03-20-15

Volunteer Application - Dearborn Public Library Page 4