VOLUNTEER APPLICATION
Tulsa City-County Library
400 Civic Center
Tulsa, OK 74103
596-7962
Last Name____________________________First Name_________________________MI___
Street Address ______________________________________________________________
City__________________________________State_____________________Zip__________
Phone (Home)_____________________________(Office)____________________________
(e-mail)_____________________________________________________________________
Age Group (circle) 13-21 22-55 56-up Birth date____
In case of emergency whom should we notify?
Name____________________________________________________Phone______________
Name of Physician___________________________________________Phone_____________
CHILDREN AT HOME:_____________________________ AGES:_______________________
EDUCATION/MAJOR:__________________________________________________________
COMMUNITY OR PROFESSIONAL GROUPS:_________________________________________
____________________________________________________________________________
VOLUNTEER EXPERIENCE:_______________________________________________________
____________________________________________________________________________
INTERESTS/ SPECIAL SKILLS/ TALENTS (music, art, computers, typing, writing, working with children, etc.): ________________________________________________________________________
_____________________________________________________________________
Availability: What day(s) of the week are you available? (circle)
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
What time during the day(s) are you available? (circle)
Mornings: 9 am - Noon Afternoons: 1 pm - 4 pm Evenings: 6 pm - 9 pm Other_______
Commitment: How often can you volunteer? (circle)
3 times per week 2 times per week Once per week
Volunteer Location: At which library would you prefer to volunteer?____
HOW DID YOU HEAR ABOUT THE LIBRARY’S VOLUNTEER PROGRAM:
_________________________________________________________________________
APPLICATION DATE:______________ ASSIGNMENT STARTING DATE:_____
PROSPECTIVE PLACEMENT:__________
DATE SENT TO BRANCH/ DEPT.______