Applicants under 18 years of age must have a parent or guardian sign this application.

Fields marked with a red asterisk (*) are required to be answered.

Personal Information

Last Name *

First Name *

Middle Name

Address *

City *

State *

Zip Code *

Phone *

Email Address *

Age (if under 18, a parent or guardian must sign this application) *

Emergency Contact

First Name *

Last Name *

Relationship *

Contact Phone Number *

Availability

Days Available *

Shift Preference *

Mornings (9:00 - 12:00)

Afternoons (12:00 - 5:00)

Evenings (5:00 - 9:00)

Other: Other:

Hours Per Week Available *

Is this required for school referral? *

Is this required for a court referral? *

Number of Hours Required *

Deadline * +

Preferred Branch Location *

Additional Branch Location

Experiences and Skill Sets

Please describe your work and/or volunteer experiences

Please describe your skills, hobbies, and interests

Preferred Volunteer Duties

References

Please list two people who know you and can attest to your character, skills, and dependability.

Reference 1

Name *

Relationship *

Phone *

Reference 2

Name *

Relationship *

Phone *

Photo/Video Release Agreement

Please check an option below. *

I hereby grant to the Fresno County Public Library the irrevocable and unrestricted right to use and publish videos and/or photographs of me, or in which i may be included in connection with volunteering, for library publications, electronic reproductions (web sites) and/or promotional materials or any other purpose and in any manner or medium. In addition, I grant my permission to alter the same without restriction, and to copyright the same. Names will not be used in any promotional materials. I hereby release the photographer/videographer and the Fresno County Public Library from all claims and liability relating to said photographs and/or videos.

I DO NOT grant my permission to the Fresno County Public Library to use and publish videos and/or photographs of me for any purpose.

Applicant Signature *

clear

Date * +

Photo/Video Release Agreement

Please check an option below. *

I hereby grant to the Fresno County Public Library the irrevocable and unrestricted right to use and publish videos and/or photographs of my child, or in which my child may be included in connection with volunteering, for library publications, electronic reproductions (web sites) and/or promotional materials or any other purpose and in any manner or medium. In addition, I grant my permission to alter the same without restriction, and to copyright the same. Names will not be used in any promotional materials. I hereby release the photographer/videographer and the Fresno County Public Library from all claims and liability relating to said photographs and/or videos.

I DO NOT grant my permission to the Fresno County Public Library to use and publish videos and/or photographs of my child for any purpose.

Applicant's Parent or Guardian Signature *

clear

Date * +

Workers' Compensation and Hold Harmless Agreement

PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING AND DATING.

I understand that nothing contained in this application is intended to create a contract for the providing of any benefit or to obligate the County of Fresno or the Fresno County Public Library in any way. If a volunteer position is established, I understand that I have the right to terminate my volunteer position for any reason at any time and the Fresno County Public Library retains the same right. No promises, statements, or representatives are binding on the County of Fresno or the Fresno County Public Library.

In consideration of the County of Fresno authorizing me to participate as a volunteer for the Fresno County Public Library, I understand that I am covered under the County of Fresno’s workers’ compensation insurance plan for medical treatment of injuries sustained while performing assigned volunteer duties. I hereby agree that workers’ compensation is my exclusive remedy and that I will indemnify and hold harmless the County of Fresno and its officers, employees and agents from any other losses, liabilities, damages, costs, actions, claims, or demands of any kind whatsoever which may arise or be in connection with my voluntary participation with the Fresno County Public Library.

Applicant Signature *

clear

Date * +

Workers' Compensation and Hold Harmless Agreement for Minors Aged 14-17

PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING AND DATING.

I understand that nothing contained in this application is intended to create a contract for the providing of any benefit or to obligate the County of Fresno or the Fresno County Public Library in any way. If a volunteer position is established, I understand that I have the right to terminate my volunteer position for any reason at any time and the Fresno County Public Library retains the same right. No promises, statements, or representatives are binding on the County of Fresno or the Fresno County Public Library.

In consideration of the County of Fresno authorizing my minor child to participate as a volunteer for the Fresno County Public Library, I understand that my child is covered under the County of Fresno’s workers’ compensation insurance plan for medical treatment of injuries sustained while performing assigned volunteer duties. I hereby agree that workers’ compensation is my exclusive remedy and that I will indemnify and hold harmless the County of Fresno and its officers, employees and agents from any other losses, liabilities, damages, costs, actions, claims, or demands of any kind whatsoever which may arise or be in connection with my child’s voluntary participation with the Fresno County Public Library.

Applicant Signature *

clear

Date * +

Applicant's Parent or Guardian Signature *

clear

Name of Parent or Guardian *

Date * +

Indemnity and Hold Harmless Agreement for Minors Under the Age of 14

PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING AND DATING.

I understand that nothing contained in this application is intended to create a contract for the providing of any benefit or to obligate the County of Fresno or the Fresno County Public Library in any way. If a volunteer position is established, I understand that I have the right to terminate my volunteer position for any reason at any time and the Fresno County Public Library retains the same right. No promises, statements, or representatives are binding on the County of Fresno or the Fresno County Public Library.

In consideration of the County of Fresno authorizing my minor child to participate as a volunteer for the Fresno County Public Library, I understand that my child is under 14 years of age and is not covered under the County of Fresno’s workers’ compensation plan. I hereby agree to indemnify and hold harmless the County of Fresno and its officers, employees and agents from any losses, liabilities, damages, costs, actions, claims, or demands of any kind whatsoever which may arise or be in connection with my minor child’s voluntary participation with the Fresno County Public Library.

Applicant Signature *

clear

Date * +

Applicant's Parent or Guardian Signature *

clear

Name of Parent or Guardian *

Date * +

Auberry	Big Creek	Bear Mountain
Betty Rodriguez	Big Creek	Biola
Bookmobile	Caruthers	Central
Clovis	Easton	Fig Garden
Firebaugh	Fowler	Gillis
Kerman	Kingsburg	Laton
Literacy Services Center	Mendota	Mosqueda
Orange Cove	Parlier	Piedra
Pinedale	Politi	Reedley
Riverdale	San Joaquin	San Joaquin Valley Heritage and Genealogy Center
Sanger	Selma	Shaver Lake
Sunnyside	Talking Book Library for the Blind	Teague
Tranquillity	West Fresno	Woodward Park
Other Other