Teen Volunteer Application
Personal Information
First name:
*
Last name:
*
Street 1:
*
Street 2:
Street 3:
City:
*
State:
Choose
AR
*
Zip:
*
Home phone:
Cell phone:
Other phone:
Demographic Information
Date of birth:
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
*
Age:
Gender:
Choose
Female
Male
Emergency Contact Information
First name:
*
Last name:
*
Street 1:
*
Street 2:
Street 3:
City:
*
State:
Choose
AR
*
Zip:
*
Home phone:
Cell phone:
Other phone:
Email address:
*
Relationship:
Choose
Co-worker
Daughter
Father
Friend
Mother
Neighbor
Son
Spouse
Supervisor
*
Email Preferences
The Bentonville Public Library utilizes a program called VicNet to record volunteer hours, inform volunteers of news, schedule changes and volunteer opportunities. However, we will not send you any e-mail you prefer not to receive. Please enter an active e-mail address, and create a unique password for access to your volunteer record. If you do not have an e-mail, leave these fields blank.
Email address:
*
Please enter a password that:
Is between 6 and 30 characters long
Password:
*
Confirm password:
*
What kinds of email would you like to receive?
Electronic newsletters
Recruitment appeals
Checklist reminders
Schedule
Please indicate your preferred schedule.
Mon
Tue
Wed
Thu
Fri
Sat
From:
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
To:
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
My availability is:
Choose
Ongoing
Ongoing, except between these dates
Only between these dates
*
I would like to serve up to:
hours:
Choose
Daily
Monthly
One time
Weekly
Motivation for Volunteer Service
Please explain why you are interested in volunteering with the Bentonville Public Library.
Teen Volunteer Agreement and Liability Waiver
By clicking the "I Agree" check box on this volunteer agreement and liability waiver, I agree to the following:
I agree to follow the schedule assigned by the library. I understand that I must give at least 24 hours’ notice if I cannot be at the library during my scheduled shift. If I am unable to be at the library during my assigned shift due to an emergency, or if I am are running late, I will contact Sue Ann Pekel (Childrens Librarian).
I understand that if I miss a total of three shifts without notifying Sue Ann Pekel I will be removed from the volunteer schedule, and no letters of recommendation will be provided for me.
I understand that I must check in with Sue Ann Pekel at my arrival to the library (If Mrs. Pekel is unavailable, the Children’s department staff will be able to assist).
I understand that I will dress in appropriate clothing, and meet the public school guidelines for dress code.
I understand that I must behave courteously to library staff and patrons, and will refrain from excessive use of my cell phone or socializing with my friends while volunteering.
FOR PARENTS/GUARDIANS TO READ WITH TEENS
I understand that my “Minor Child” is a “Volunteer” for the Bentonville Public Library, BPL. As a volunteer, I understand that they will not be compensated (financially, or in any other manner) for their volunteer time. I further understand that they are not an employee of BPL or the City of Bentonville, COB, and are not entitled to any benefits that are provided to employees of the City. I further understand that should they apply for future job openings, BPL or COB is under no obligation to hire them.
I understand that their volunteer service may be terminated at any time and for any reason by themselves, or the library administration, with or without notice. As a library volunteer, they will try and provide a minimum of 2 weeks’ notice to the library staff to end their volunteer service.
As a volunteer, I understand that they are under no obligation to perform duties that they feel may be outside the scope of their physical abilities or which they consider hazardous to their health or well being. The BPL and the COB are not responsible for any injuries they may sustain while volunteering.
As a library volunteer, they are considered a library advocate and supporter and they agree to perform their volunteer duties in a professional and creditable manner and act in the best interests of BPL.
I release, waive, discharge, and covenant on behalf of myself and my minor children not to sue COB, their elected and appointed officials, agents, volunteers, and employees (“Releasees”) from all liability to me, or my minor children, for any loss or damage, and any claim or demands on account of personal or property injury or because of my, or my minor children’s death, whether caused by Releasees’ negligence or otherwise, while I, and my minor children, participate in the COB Municipal Volunteer Program.
I further agree to defend, indemnify, and hold harmless the City and its officers, employees and agents, from and against any and all claims, suits, actions, liability judgment and expenses that may arise by reason of services I, or my minor children, provide as a volunteer or that are connected in any way therewith. I will pay all costs incident to any claim, including, without limitation, attorneys’ fees.
I expressly agree that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the State of Arkansas and that if any portion is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.
I grant permission for the City to use my, or my minor children’s image, filmed or photographed during volunteer activities, to promote its services and programs.
In case of serious injury, I give my permission for City personnel to seek any medical treatment should it become necessary.
I have read and voluntarily sign this release, waiver of liability, and indemnity agreement, and further agree that no oral representations, statements, or inducement apart from the foregoing written agreement have been made.
I Agree
Continue