Volunteer Application Form

Yes, I want to volunteer at the library! I understand that I am applying for an unpaid/voluntary position that is subject to availability.

Basic Information

First name:

Last name:

Middle name:

Type:

Street 1:

Street 2:

City:

State:

* Zip: *

Home phone:

Email address:

Date of birth:

Account Setup

Please enter a password that:

Is between 4 and 30 characters long

Password:

Confirm password:

For Applicants Under 18

If the applicant is under 18 years old, please provide the first and last name of a parent or legal guardian and that person's relationship to the applicant.

First name:

Last name:

Relationship to minor:

Emergency Contact

Please enter contact information for someone in case of an emergency.

Relationship to applicant:

First name:

Last name:

Home phone:

Demographics

You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.

Are you a student?:

Are you a DSBPC Career Academy Student?:

Which DSBPC academy do you attend?:

Which DSBPC school do you attend?:

What is your employment status?:

Job Function Interests

Please let us know which job functions you are most interested in doing. Please note that not all job functions are available at all locations. Read details of each job function at: http://www.pascolibraries.org/supporters/volunteering/

Branch Placement

Please let us know which library branch(es) you are interested in volunteering at:

* Site Preference:

Legal Disclaimers

DEPARTMENT RELEASES, WAIVERS AND BACKGROUND CHECKS

The level of the background check is determined by the Volunteer/Intern position. Note: Sexual Offender/ Predator background checks are part of the background check process. The applicant or parent/guardian of the applicant may be required to complete a department specific application and release/waiver prior to commencement of Volunteer/Intern placement. Volunteer/Intern positions are subject to availability and department approval and may be terminated by either party at any time.

GENERAL RELEASE AND WAIVER OF LIABILITY TO BE COMPLETED BY ADULT APPLICANT OR PARENT/GUARDIAN OF MINOR APPLICANT

I, the above applicant/participant or parent/guardian of above minor applicant/participant, if accepted to perform Volunteer/Intern service, assume all risk of personal injury and/or property damage from whatever causes arising in conjunction with participation in same. I/We hereby release the Pasco County Board of County Commissioners, the individual members of said Board, the director, agents or other employees of the Board of any liability or contribution to such liability, before, during or after participation and/or transport to and from. I/We further state that the foregoing Release and Waiver of Liability has been carefully read and that I/We understand the contents and have acknowledged the same of my/our own free act.

AFFIDAVIT OF SKILLS, ABILITIES, KNOWLEDGE AND COMPETENCY TO BE COMPLETED BY ADULT APPLICANT OR PARENT/GUARDIAN OF MINOR APPLICANT

I, the above applicant/participant or parent/guardian of above minor applicant/participant affirm that I or my minor child/ward have the skills, abilities and knowledge necessary to safely and competently perform the responsibilities and duties of the volunteer position or internship that I or my minor child/ward is applying to.

I Agree