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Library Volunteer Application
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The City of Anacortes values volunteers. Volunteers enable us to utilize the extraordinary reserve of knowledge, talent, and skill possessed by members of our community and to capitalize on these abilities to augment City services. We seek residents interested in local government and provide an opportunity to perform work of value to the community. The volunteer application is designed to give applicants an opportunity to share their background, experience, interests and skills, enabling the City to make the best possible volunteer placement.
Contact Information
First Name
*
Last Name
*
Address
*
City
*
State
*
Zip Code
*
Phone Number
*
Email Adress
*
Are you over the age of 18?
*
Yes
No
If no, please give date of birth
Have you ever volunteered for the library before?
*
Yes
No
If yes, give volunteer date(s)
Are you currently certified in CPR?
*
Yes
No
If yes, date certified
Availabilty
During which days are you available for volunteer assignments?
*
Weekday Mornings
Weekday Afternoons
Weekday Evenings
Weekend Mornings
Weekend Afternoons
Weekend Evenings
What day of the Week?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Volunteer Duration
*
Long-term
Short-term
Special Project
Not sure
Special Skills or Qualifications
Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities.
*
Previous Volunteer Experience
Summarize your previous volunteer experience.
*
Criminal Convictions
Have you been convicted of a felony or plead guilty or no contest to a felony or misdemeanor other than minor traffic offenses within the past three (3) years?
*
YES
NO
If yes, please complete the following (a conviction record will not necessarily be a bar to employment)
Conviction
Location
Date
Medical Conditions
Do You Have Any Medical Conditions Physical or Emotional That Should Be Taken Into Consideration in Arranging Volunteer Assignments?
*
Yes
No
If yes, please explain:
References (Do Not List Relatives)
Name
*
Phone Number:
*
Name
Phone Number:
Person to Notify in Case of Emergency
Name and relation
*
Home Phone
*
Work phone
*
Email address
*
Agreement and Signature
To the best of my knowledge, the information herein is true and complete and I understand that falsification of this application is grounds for dismissal as a volunteer. I give permission for an authorized representative of the City to contact any and all references I have given on my application, inquire of individuals about my ability to perform all aspects of the volunteer position for which I am being considered and to conduct a state patrol criminal background check in accordance with RCW 43.43.830-839. I furthermore release the City of Anacortes and those individuals/institutions that provide information from any liability that may arise from the provision of this information.
As a volunteer for the City of Anacortes, I am fully aware that the work associated with being a City Volunteer involves certain risks of physical injury or death. Being fully informed as to these risks and in consideration of my being allowed to participate in the City’s Volunteer Program, I hereby assume all risk of injury, damage and harm to myself arising from such activities or use of City facilities. I also hereby individually and on behalf of my heirs, executors and assignees, release and hold harmless the City of Anacortes, its officials, employees and agents and waive any right of recovery that I might have to bring a claim or a lawsuit against them for any personal injury, death or other consequences occurring to me arising out of my volunteer activities.
By signing below you agree to the terms above.
Full Name
*
Parent or Guardian’s Signature if Under 18
*
Date
*
Notice to Volunteers
Volunteers are not considered to be City of Anacortes employees. Injury Compensation is provided through the Department of Labor & Industries. Volunteer service is considered to be creditable work experience. The data furnished on this form is furnished voluntarily and will be used to contact, interview and place volunteers.
Thank you for completing this application form and for your interest in volunteering with the City of Anacortes.
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