2. General Information

4. First Name*
5. Middle Name
6. Last Name*
8. Home Address
10. City
11. State
12. ZIP Code
14. Phone Number*
16. Email Address
18. Pronouns
19. Preferred Name
21. Emergency Contact
22. Emergency Contact Phone Number
24. Preferred Library Branch*
    -- Select One --Hardwood Creek Library, Forest LakeLake Elmo LibraryOakdale LibraryR.H. Stafford Library, WoodburyValley Library, LakelandWildwood Library, Mahtomedi
26. Have you been convicted for a violation of the law other than a minor traffic ticket?
    -- Select One --YesNo
27. If Yes, Please Explain
29. Are you volunteering to fulfill court-mandated service?
    -- Select One --YesNo
30. If Yes, please indicate how many hours are required and your required completion date.

34. Time Commitment

    Please indicate how long you would like to commit to the library. Special projects may be available for less than a six-month commitment.

36. Preferred Time Commitment*
    -- Select One --3 to 6 months6 to 12 monthsOther
37. If Other, please explain.
39. When are you available?*

    1. Sunday afternoons
    2. Monday mornings
    3. Monday afternoons
    4. Monday evenings
    5. Tuesday mornings
    6. Tuesday afternoons

    1. Tuesday evenings
    2. Wednesday mornings
    3. Wednesday afternoons
    4. Wednesday evenings
    5. Thursday mornings
    6. Thursday afternoons

    1. Thursday evenings
    2. Friday mornings
    3. Friday afternoons
    4. Saturday mornings
    5. Saturday afternoons

43. Work Experience and Relevant Skills

45. Work Experience

    Please list past work experience, including volunteer work. Highlight any experience that you feel might be applicable to library work. 

47. Other Skills

    List other skills and special knowledge or education you have which might be beneficial to the library.

49. Interest in Volunteering

    What interests you about volunteering at the library, and what are you hoping to learn or experience during your time with us?

51. Do you have a medical condition or mobility restriction that would limit your ability to perform certain tasks without reasonable accommodation?*
    -- Select One --YesNo
52. If Yes, please explain.

56. References

    Please list two employers, supervisors, teachers, or other non-relatives we may contact for a reference.

58. Reference Name
59. Reference Occupation
60. Reference Phone Number
62. Reference Name
63. Reference Occupation
64. Reference Phone Number

66. Washington County will not discriminate against or harass any volunteer or volunteer applicant because of race, creed, religion, national origin, sex, mental or physical disability, age, marital status, or status with regard to public assistance, sexual orientation, familial status or politics.

68. I certify that all statements made on this application are true, complete and correct to the best of my knowledge and belief. I understand these statements are subject to verification. I understand that falsification of this application will disqualify me from selection or result in dismissal.*
    -- Select One --I agree.I disagree.
70. Tennessen Warning for Volunteers

    This application is to assist in the process of referring you to the Washington County Library for a possible position as a volunteer. Certain information requested on the application is private, that is, it may be released only to you or the Washington County Library.

Leave This Blank:


72. 1. Receive an email copy of this form.
73. Email address

    This field is not part of the form submission.

74. Submit

* indicates a required field