Volunteer Application Details

Date…………………

Name: Mr Mrs Ms Miss

……………………………………..........................................................................

Address
………………………………………………………………………………..

Phone ……………………Mobile…………………….

Email …………………………………………………..
______________________________________________________________

Days Available……………………………………………………………….

Times Available………………………………………………………………………

Volunteer area of interest: Branch Activity or Home Library Service

Do you have a car? Yes No

Are you willing to use your car in your volunteer tasks? Yes No

Do you have a current driver’s licence? Yes No

Do you have comprehensive car insurance? Yes No

Do you have any medical conditions that may affect your volunteer capacity?
Yes No

If yes please specify

…………………………………………………………………………………………..

…………………………………………………………………………………………..

Languages spoken other than English

…………………………………………………………………………………………..

…………………………………………………………………………………………..

Skills Register
…………………………………………………………………………………………
…………………………………………………………………………………………
Person to contact in case of emergency:

Name:…………………………………………………………………………….

Address:………………………………………………………………………….

…………………………………………………………………………………..

Relationship:…………………………………

Telephone numbers : ……………………b/h ……………………………a/h

Mobile: …………………………………….

I have read and understood the content of this document and confirm that the
information provided is true and correct. I will take full responsibility to make
sure my details our accurate and will notify any changes within 14 days.

Signature : ……………………………….

Print name: ………………………………

Date: ………………

If applicant is under the age of 18 years parent or guardian permission must

be given for individual to volunteer
I the undersigned give permission for ………………………………to volunteer
at Yarra Plenty Library.

Name ………………………………………Relationship …………………………..

Signature…………………………………….Date………………………..

Office use only:

Date application received at Outreach Dept: ……………………

Interview date : ………………

Police check sent: …………… Police check received………………………

Supervisor: …………………….. Branch : …………………

Interviewed by: …………………………….

Review Dates:
………………………………………………………………………….