Volunteer Application Please be prepared to provide references on this application. You will also be asked to choose which volunteer opportunities you are interested in. Personal InformationName* First Middle Initial Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone 1*Phone 2Email* You must be at least 12 years old to volunteer. Are you 18 or older?* Yes No If no, date of birth MM slash DD slash YYYY In case of emergency, notify*NamePhoneRelationshipOccupation and/or EducationChoose the highest grade completed* 9 10 11 12 College If College, years or degree completed Current Employer and Position Are you a student?* Yes No Which school do you attend? Volunteer InterestAt which library would you like to volunteer?*BensalemDoylestownLanghorneLevittownPerkasieQuakertownYardleyFor each day, indicate times you are available to work a two-or three-hour shift*MondayTuesdayWednesdayThursdayFridaySaturdayPlease select one: I am interested in volunteering indefinitely. I am interested in volunteering through a certain date: DateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Tell us which areas you are interested in volunteering* Book Club Leader Building Caregiver Collection Care Assistant Community Ambassador Greeter Grounds Caregiver Holds Processor Movie Matinee Leader Penn’s Little Village Volunteer Shelf Organizer Special Events Assistant Summer Quest Assistant Not Sure VolunteeringHow will volunteering at the library help you meet your personal goals?*SkillsWhat special interests and skills do you have that will help us to match you with the best assignment?*AccommodationsPlease list any physical or other accommodations you may requireReference InformationPlease give two personal or professional references*Personal or Professional?NamePhone*Personal or Professional?NamePhoneHave you ever been convicted of a crime that has not been expunged or pardoned, other than a minor traffic violation?* Yes No If yes, please explainA conviction will not necessarily preclude your volunteering. This information will be used only for volunteer-related purposes and only to the extent permitted by applicable law.* I understand that I will need to obtain background checks in order to volunteer.*Consent* By checking this box and typing my name, I authorize Bucks County Free Library to make inquiries as to my experience and character and I certify that all information on this form is true and correct to the best of my ability.*Electronic Signature* * I understand if I am under age 18 that I'll need to have a signed parent or guardian consent form before starting work.*Electronic Guardian Signature