First Name: Middle: Last:
Address:
City: State: Zip Code:
Phone: (Day) (Evening)
E-mail Address:
Date of Birth: Month Day Year
Emergency Contact Name:
Emergency Contact Phone Number:
Do you have any limitations you wish us to know about?
Check all that apply to you.
List any other educational or volunteer experience you would like us to know about:
Some companies make charitable donations to non-profit organizations if employees retired or active and/or their immediate family members volunteer.
Occupation:
Current Employer: Title:
Retired from: Title:
Spouse's employer:
Parent or Guardian's employer:
Check which jobs interest you the most:
At what times are you interested in volunteering? Check all that apply.
Please list any times that you are unable to volunteer:
How did you hear about us? Check all that apply.
Why would you like to volunteer with the Louisville Free Public Library?
Thank you for taking the time to give us this information. The Louisville Free Public Library will hold all personal information in strict confidence, but your volunteer hours are tracked and may be shared with the Library Foundation for donation requests with employers. The Library reserves the right to screen and select volunteers based on aptitude and library needs, as well as to determine all volunteer placements and job assignments. We look forward to working with you!
