* - Required field

Basic Information
* First Name
Middle Name
* Last Name
Date of Birth
Home Phone
Cell Phone
Email Address
* Preferred mailing type
Physical (Home) Address
* Physical (Home) Address 1
Physical (Home) Address 2
* Physical (Home) City
* Physical (Home) State
* Physical (Home) Zip Code
Mailing Address
* Mailing Address 1
Mailing Address 2
* Mailing City
* Mailing State
* Mailing Zip Code
Education
Education level
Major / Subject / Degree
Employment Information
Are you currently employed?
YesNo
Current Employment
* Business Name
Hire Date
Hours per week
* Business Address 1
Business Address 2
* Business City
* Business State
* Business Zip Code
Work Phone
Fax
May we contact you at work?
YesNo
Brief Job Description
Previous Work Experience
Volunteer Information
How did you learn about our programs?
Referred by:
Volunteer History
Previous Volunteer Experience
Youth Experience
What do you hope/expect to gain from this volunteer experience?
Volunteer Availability
AvailabilityPlease select day of the week, then times will appear below.
Monday Availability
Tuesday Availability
Wednesday Availability
Thursday Availability
Friday Availability
Volunteer Preferences
Gender Preference
MaleFemaleNo Preference
Grade Level Preference
Bilingual student?
YesNo
Meeting Place
Other Meeting Place:
Volunteer Activities
Other Volunteer Activities:
Additional Information
Foreign language
Have you ever been arrested/convicted?
YesNo
If yes, please explain:
Do you have a library card?
YesNo
References
Reference 1
First Name
Last Name
Address
City
State
Zip Code
Phone
Reference 2
First Name
Last Name
Address
City
State
Zip Code
Phone
Reference 3
First Name
Last Name
Address
City
State
Zip Code
Phone
Emergency Contacts
Emergency Contact 1
Full Name
Phone
Relationship
Emergency Contact 2
Full Name
Phone
Relationship
Waiver and Release Forms
Click here to read our Volunteer Handbook.

The Literacy Project/Study Friends Program Adult Waiver for All Sponsored Activities
I hereby acknowledge that the various activities sponsored by The Literacy Project/Study Friends Program may result in injury to the participant. I hereby assume all risk of personal injury or death and property damage from any causes arising while I am participating in such activity, and further release The Literacy Project/Study Friends Program, their officers, employees, agents, servants, and all representatives and sponsors from any liability therefore and contribution of such liability, including liability resulting from the negligence of said individuals.

I also authorize and consent to any emergency x-ray examination, medical diagnosis, or treatment and hospital care to be rendered unto myself under the general supervision and on the advice of any physician licensed to practice in the State of Colorado.

I understand that there are two exceptions to the promise of confidentiality. If information is revealed concerning suicide, homicide, or child abuse and neglect, it is required by law that this be reported to the proper authorities.

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* Applicant Full Name
* Date
Study Friends Authorization to Release Information
As an applicant to The Literacy Project/Study Friends Program for the position of Volunteer Tutor, I understand I am required to make available information for use in determining my suitability.

I therefore authorize The Literacy Project and its Study Friends Program to make such inquiries of my past and current employers, educational institutions, persons, law enforcement agencies, medical institutions or professionals, companies, and corporations to release information they may have about me that is deemed related to this position I am applying for, and I release them, as well as The Literacy Project and it Study Friends Program, from any liability and responsibility from doing so.

This authorization in original and copy form shall be valid for this and any future information that may be requested.

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* Applicant Full Name
* Date
Photography Release
I, the undersigned, do hereby consent and agree that The Literacy Project, its employees, or agents have the right to take photographs, videotape, or digital recordings of me beginning on the start and end dates I may choose to provide below, and to use these in any and all media, now or hereafter known, and exclusively for the purpose of promoting The Literacy Project. I further consent that my name and identity may be revealed therein or by descriptive text or commentary.

I do hereby release to The Literacy Project, its agents, and employees all rights to exhibit this work in print and electronic form publicly or privately and to market and sell copies. I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used.

I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback.

I also understand that The Literacy Project is not responsible for any expense or liability incurred as a result of my participation in this recording, including medical expenses due to any sickness or injury incurred as a result.

I represent that I am at least 18 years of age, have read and understand the foregoing statement, and am competent to execute this agreement.

* Please select one:
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* Applicant Full Name
* Date