Volunteer Application

Volunteer Application for the Rapid City Public Library

610 Quincy Street Rapid City, South Dakota 57701 | (605) 394-6139 x.2230 | Equal Opportunity Employer

Personal Information
Date (xx / xx / xxxx):
Name:
Address:
City: State: Zip:
Telephone Number: Work Phone (optional):
Email (optional):
If you are under 18, please discuss the volunteering opportunity with your parent or guardian; we will need their signature to complete the hiring process. Are you at least age 18? Yes No
Emergency Contact Information
Name:
Address:
City: State: Zip:
Phone: Email (optional):

Reference Information
Personal Reference Name (please list one):
Relation:
Address:
City: State: Zip:
Phone: Email (optional):
As part of the Rapid City Public Library volunteer employment process, we will be checking your background relative to job and personal references, criminal record, credit and social services record. In order to do that, we must have your authorization. Have you ever been convicted in a court of law? Yes No If yes, please list below any violation, other than minor traffic offenses, for which you were convicted. (One or more convictions will not necessarily disqualify you from volunteering for the Rapid City Public Library. Failure to disclose convictions may result in disqualification.)
Offense:
Date: Place:
Offense:
Date: Place:
Offense:
Date: Place:

Educational Background
Choose the highest level of education that you have completed (must be at least entering 6th grade in year of application)
Would you be interested in pursuing a career in Library Science? Yes No
List schools that you have attended from the first to last.
1) Name: Address:
Subject Studied: Dates Attended:
Degree:
2) Name: Address:
Subject Studied: Dates Attended:
Degree:
3) Name: Address:
Subject Studied: Dates Attended:
Degree:
4) Name: Address:
Subject Studied: Dates Attended:
Degree:
Work History
Are you legally authorized to work in the United States? Yes No
State your work history starting with your most recent / current job. (Please include volunteer work and babysitting work.)
1) Company Name :
Address:
Job Title: Supervisor:
Employment Dates: From To
Responsibilities:

2) Company Name :
Address:
Job Title: Supervisor:
Employment Dates: From To
Responsibilities:

3) Company Name:
Address:
Job Title: Supervisor:
Employment Dates: From To
Responsibilities:

Interests and Skills
List any interests and special skills that you have and feel would be applicable to work as a library volunteer.
Please list any computer skills you have and software that you are familiar with.
Place a check mark next to positions for which you would be interested in applying.
Technical Services Assistant	Reference Assistant
Circulation Assistant	Outreach Selector
Periodicals Assistant	Youth Services Assistant
Home Delivery Service Assistant
Availability
Regularly each week for hours per week
For a total of hours	Periodically on an on call basis
Summer only	Winter only
Other, please specify
Do you have a valid drivers license? Yes No If yes, please fill in the number and the state it was issued from:
How did you hear about volunteer opportunities at the Rapid City Public Library?

You will be asked to sign the following during your interview: The undersigned hereby authorizes any state department of social services, any police department, and Rapid City Public Library, to obtain and/or release any and all information regarding the social services, work, credit, or criminal history of the undersigned applicant for consideration for volunteer employment by the Rapid City Public Library. The undersigned also understands that misrepresentation or omission of facts called for in the application is cause for cancellation of the application and/or separation from volunteer service.