Volunteer Application Contact details Fields marked with an * are required Today's date * Prefix * Mrs. Ms. Mr. Dr. First Name * Last Name * Individual Suffix Jr. Sr. II III IV V VI VII Birth Date * Email * Street Address * Street Address (cont...) City * State * - select State/Province - Alabama Alaska American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas United States Minor Outlying Islands Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Country United States Phone * Preferred Contact Method * Email Phone Text Why do you want to volunteer with LibJusCo? * Select all the positions you are interested in. Which positions are you interested in? * WriterWebmasterComment ModeratorAdvocateResearch AssistantCorrespondentSocial Media SpecialistMembership Assistant Check all that apply. Which days and times are you available? * Sunday A.M.Sunday P.M.Monday A.M.Monday P.M.Tuesday A.M.Tuesday P.M.Wednesday A.M.Wednesday P.M.Thursday A.M.Thursday P.M.Friday A.M.Friday P.M.Saturday A.M.Saturday P.M. List any health or physical conditions we should know about. * Highest level of education completed * List professional certifications * List relevant work or volunteer experience * List any special skills List all languages other than English you are fluent in If you are employed or self-employed, please indicate your occupation, business location, business phone, and type of duties performed. If you are not employed, please give information for the most recent job held. Employment Status * Employed Self-employed Unemployed Retired Disabled Employment details * Please provide two personal or professional references. References * Please list date and title of any criminal convictions. (this is not a disqualifier) Criminal History Probation or Parole? * Yes No Any restrictions? * Yes No If yes, explanation VOLUNTEER AGREEMENT I understand that this is an application for and not a commitment or promise of volunteer opportunity. I certify that all information provided throughout the selection process, including on this application and interviews with LibJusCo will be true, complete, and correct to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and that I have not withheld and will not withhold any information that would unfavorably affect my application for a volunteer position. I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant for a volunteer position with LibJusCo or my termination as a volunteer. I understand that the information contained on my application will be verified by LibJusCo and I hereby give permission for LibJusCo. to contact anyone it deems necessary to verify any information provided by me to discuss my suitability for a volunteer position, including my background, volunteer experience, education, or related matters. I voluntarily and knowingly waive all rights to bring an action for defamation, invasion of privacy, or similar cause of action against anyone providing such information. I understand that submission of this form will substitute for a signature until such time as I begin my volunteer assignment and I can sign a hard copy. Check this box if you agree with the above statement. Volunteer Agreement * I Agree Submit Cancel