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2. First Name*
3. Last Name*
5. Address*
7. City*
8. State*
9. Zip Code*
11. Phone Number
12. Email Address
14. Birth date*
    Birth date
15. Do you have a valid driver's license?

    1. Yes
    2. No
    3. Learner's permit only
17. Have you ever been convicted of a crime (other than a minor traffic offense)?*

    1. Yes
    2. No
19. If yes to the above, please explain.
21. Do you have any physical limitations?

    1. Yes
    2. No
23. If yes to the above, please explain.
25. Are you seeking to fill mandatory community service hours?

    1. Yes
    2. No
27. If yes to the above, please list the agency (court, school, employer) and reason.
31. Where are you willing to go for volunteer activities? (Check all that apply.)*

    1. Blue Ridge
    2. Buchanan
    3. Daleville
    4. Eagle Rock

    1. Fincastle
    2. Remote
    3. Travel to various non-library locations in the community
33. What type of commitment are you interested in? (Check all that apply.)

    1. Regular/predictable schedule
    2. Highly flexible schedule
    3. As-needed basis
    4. Weekly

    1. Monthly
    2. One-time
    3. Other
35. How many hours are you available to volunteer each month, on average?
37. List the days/times you are normally available to volunteer.
39. I prefer to work: (Check all that apply)

    1. Helping people
    2. Behind-the-scenes
    3. Solo

    1. On a team
    2. Creatively
    3. Doing routine tasks

    1. Doing manual tasks
    2. Using technology
41. Which volunteer activities interest you? (Check all that apply)

    1. Collection maintenance (shelving, shelf-reading, straightening, processing materials)
    2. Photographer or videographer (marketing, website, social media, events)
    3. Graphic design (print and/or digital signage, marketing or resources)
    4. Tutoring one-on-one (technology, research, homework help, information literacy, library skills)
    5. Teaching workshops (technology, research, STEM, information literacy, areas of expertise)
    6. Assisting with public events (setup, takedown, assemble resources, greeter, logistics)
    7. Writing and/or editing (grants, articles, guides, social media posts, instructions, lesson plans)
    8. Fundraising (searching for grants, planning events, promoting donation opportunities)
    9. Genealogy/Local History (scanning documents, research, instruction, organizing resources)
    10. Landscaping/facility (flowers, gardens, pruning, raking leaves, cleaning)
43. Tell us more about your selections above or offer something different that's not on the list!
45. Describe your skills/interests that might be helpful to the library, including technology (if applicable):
47. Describe any current/previous volunteer experience:
49. Describe any current/previous paid work experience:
51. List two references (not family members):
53. Reference #1
55. First Name*
56. Last Name*
58. Phone Number
59. Email Address
61. Reference #2
63. First Name*
64. Last Name*
66. Phone Number
67. Email Address
69. Emergency Contact
71. First Name*
72. Last Name*
74. Phone Number*
75. Alternate Phone Number

79. I confirm that all information on this form is true and correct. I understand and agree that the Botetourt County Library retains the right to select, refuse, adapt and/or terminate my volunteer involvement at any time and for any reason. 

81. Name*
82. Date*
    Date

84. Applications will be reviewed by the Volunteer Coordinator and appropriate department head. Suitability will be determined by applicant qualifications and availability in relation to current needs and best interests of the library. 

    A criminal background check may be required prior to acceptance as a library volunteer. 

88. THIS SECTION FOR MINORS ONLY (under age 18)
90. Which school do you attend?

    1. James River High School
    2. Lord Botetourt High School
    3. Central Academy Middle School

    1. Read Mountain Middle School
    2. Homeschooled
    3. Other
92. Parent/Guardian Name
93. Date
    Date
95. Parent/Guardian Phone Number
96. Parent/Guardian Email Address

98. Please note that a parent/guardian signature on print paperwork may be required prior to accepting an applicant as a library volunteer. 

Leave This Blank:


100. 1. Receive an email copy of this form.
101. Email address

     This field is not part of the form submission.

102. Submit

* indicates a required field