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Library Volunteer Application and Waiver
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Please contact the Rowlett Animal Shelter at 972-412-6219 or the Parks Department at 972-412-6263 if you need to do court ordered community service, which cannot be done at Rowlett Public Library. Each library volunteer applicant must be 16 years or older. Complete one form for each person. You may submit a completed form online, by fax, or in person. You will be called to come in for a short interview. For more information, please contact the Library Volunteer Coordinator at 972-412-6161.
Phone (Example: 8883335555):
Emergency Contact Name:
Emergency Contact Phone:
What type of volunteer task(s) are you interested in?
Tutor ESL (English as a Second Language)
Keep shelves in order
Other (please specify to Volunteer Coordinator)
Do you have any talents/professional skills you can use or share while volunteering at the library? If so, please list what skills:
List any languages, other than English, which you can speak fluently:
Volunteer Availability (Please Note: Your actual volunteer schedule may vary depending on library needs and availability. This will be talked about in the short interview.):
Are you volunteering to receive credit for a school/college/ organization?
If yes, what is the name of the school/college/ organization?
By what date do you need to complete your volunteer hours?
Please list two references (volunteer organizations, school, business, friend):
Reference Name #1:
Reference Phone #1:
Reference Name #2:
Reference Phone #2:
Please complete the "Volunteer Waiver" below. The form must be completed before your application can be processed. You may submit the completed "Volunteer Waiver," as well as the "Volunteer Application," either online, by fax, or in person. Thank you for your spirit of volunteerism!
By checking the "Agree" boxes below, I affirm that I understand the rules and guidelines of the Volunteer Waiver.
I agree not to consume or use tobacco products on any volunteer assignment.
I agree not to consume, use, possess or be under the influence of any drug or alcohol products on any volunteer work assignment.
I agree not to repeat to any outside source confidential information obtained while I am a volunteer with the City of Rowlett. I realize that this is privileged information and is not to be shared with anyone other than a current employee of the City of Rowlett, and then only as necessary to carry out my task and/or assignment.
I grant the City of Rowlett permission to use my likeness, voice, photograph and words in any form for promotional activities without payment.
I grant the City of Rowlett permission to perform a criminal background check, understanding that participation in the Volunteer Program is contingent upon the results.
I understand that any pattern of conduct that would tend to disrupt, diminish or otherwise jeopardize public trust in the City of Rowlett will result in dismissal.
I understand that my volunteer assignment with the City of Rowlett may be terminated at any time.
I understand my involvement with the City of Rowlett may include coverage in the media. I approve the use of my likeness, voice, photograph, words and any other creative work without payment or consideration by the media or the City of Rowlett.
Waiver of Liability
In consideration of the City of Rowlett allowing me to participate in the Volunteer Program, and being aware of the possible injuries that could occur as a result of that participation, I on behalf of myself (my minor child / children) release the City of Rowlett officials, employees, agents, instructors from any and all injuries and damages whatsoever arising from participation in the Volunteer Program. I, my heirs and representatives , agree to indemnify, save and hold harmless the City of Rowlett, its officials, employees and agents from any and all claims made by me (my child / children) or my insurer for injuries or damages related to participation in the Volunteer Program. I certify that all information provided on this application and during the interview process is true and complete. I understand that falsification or significant omissions of any information may be considered justification for non-acceptance or dismissal if discovered at a later date and that appointment to a volunteer position may be contingent upon the completion and review of a criminal background check.
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