Welcome to the Licking County Library

Volunteer Application

Ex: John
Ex: Smith
Ex: 123 Main St., Newark, OH 43055
Ex: 555.555.5555
Ex: johnsmith55@gmail.com



Ex: Jane Smith
Please list a number for you emergency contact
How are you related to your emergency contact?
Other Information
Highest grade completed
Please list your employer, dates employed, and what were your duties?
Please list any volunteer experiences, if applicable
Please describe the community service hours needed. Are they needed for school? work? court ordered? How many hours are required, by when?
Are you applying for a specific volunteer position? If so, which one?







Applicants must be 14 years of age or older. Applicants under 18 require consent of a legal guardian.
I understand that I must submit to a background check before being assigned any volunteer responsibility at Licking County Library. Cost of processing background check is $18.27. After one hundred hours of volunteer service, you may request a reimbursement.
I certify that all statements made in my volunteer application are true and correct to the best of my knowledge. I give the Licking County Library permission to verify all information contained in this application as may be necessary.
Please type your name to acknowledge that the information provided in this form is correct?