Fillable Volunteer Application (City of Longview)

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Volunteer Application (City of Longview)

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Country of origin: US
File type: PDF

U.S.A. forms for City of Longview

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Volunteer Application
Application Date:
Full Name: Date of Birth:
Home Address:
City: State: Zip:
Mailing Address if different:
City: State: Zip:
Primary Phone: Secondary Phone:
Email: Fax:
Preferred contact time: Hours available per week:
Emergency Contact: Phone:
Driver’s License #
(Must attach copy) State: Expires:
Education: Circle last year of school completed. Area of study or interest. Year:
8, 9, 10, 11, 12 Some college, Bachelors, Masters, Doctoral
Training or Skills:
Languages other than English:
Do you have any condition which would limit your volunteer activities?
If yes, please explain:
What days are you available?
Current or recent employer:
Your position:
Address: Phone:
Nam
e: Relationship to you:
Address: Phone:
Name: Relationship to you:
Address: Phone:
Name: Relationship to you:
Address: Phone:
1 of 2
References:
2 of 2
___
_
____
____
____
Please read each statement and inial on the appropriate line.
_____ I agree to abide by all of the Policies and Procedures of the City of Longview while volunteering.
_____ I agree not to consume use, possess, or be under the inuence of any drugs or alcohol products while volunteering.
_____ I agree that any conduct or paern of conduct that would tend to disrupt, diminish, or otherwise negavely aect public
percepon of the City of Longview will result in dismissal with no prior noce or warning.
_____ I agree that my volunteer assignment will have a trial and assessment period.
_____ I agree that my volunteer assignment may be changed, ended or terminated at any me.
_____
I agree that depending upon the nature of the volunteer assignment, the City of Longview may deem is necessary to obtain
a Driver’s License Record and or a Criminal Convicon History and Wanted Informaon Reports on individuals volunteering for the
City of Longview. I hereby consent to the City of Longview to make any requests for a Driver’s License Record, a Criminal History
Report, and or a Wanted Informaon Report on me. I release, relinquish, and remise the City of Longview, its employees, agents,
and representaves, from any and all causes of acon or liability which I may have or which arise out of, or as a result of, the re-
ports herein authorized. Furthermore, I understand that my failure to execute this informed consent will result in my not being
further considered for employment or volunteerism.
_____ I have NOT been convicted and or placed on probaon for any criminal oense.
If you HAVE been convicted and or placed on probaon, then list the date and type of the oense.
______________________________________________________________________________________________________
______________________________________________________________________________________________________
By signing I agree to the above statements.
Signature: _____________________________________________________________ Date: ____________________________
Full Name (Please Print) ___________________________________________________________________________________
Please call or e-mail Taylor Harding to set up a screening interview.
903-237-1346 or tharding@longviewtexas.gov
Computer Classes
Clerical
Computer Monitor
Data Entry
Greeter
Little Free Libraries
Maintain Book Shelves
Friends Book Sale
Special Collections Archives
Special Events
Tutoring
Process Items
Repair Books
Are you needing Community Service Hours?
How Many?
___
____
___
___
___
___
___
___
___
___
Book Finder
Yes
No
Please return the completed application to the Longview Public Library
222 W. Cotton St., Longview, TX 75601
___
Why would you like to volunteer?
Select all categories that interest you:
Statement of Agreement
903-237-1350
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Volunteer Application (City of Longview)

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Completed 3 August 2020

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