Elmhurst Public Library
School Year Volunteer Application for Middle School Students

Name: ___________________________________________________________________________

Address: _____________________________________ Phone: _____________________________

Age: _____ School: __________________________ Grade:_____ Today's Date: ______________

Person to contact in case of emergency: _______________________________________________

Relationship: __________________________ Their Number: _______________________________

Please tell us the days and times you are willing and able to work. (The library is open
9:00a.m. to 9:00p.m. on weekdays, 9:00a.m. to 5:00p.m. on Saturdays, and 1:00 to 5:00p.m. on
Sundays. People under the age of 16 may not work after 7p.m. during the school year.)

Do you think you have a special talent that could be used in your volunteer work? If so, what?

_________________________________________________________________________________

Do you need volunteer hours for a specific reason? If yes, why, and by what date do you need to
complete your hours?

________________________________________________ Date I need to finish by: ____________

My child: ___________________________________ has my permission to work as a Middle School Volunteer at the Elmhurst Public Library. My child and I have read the attached information sheet and he/she will abide by the standards outlined.

Parent's Signature: ____________________________________________ Date: _______________

Applicant's Signature: __________________________________________ Date: _______________

Elmhurst Public Library 125 S. Prospect Ave., Elmhurst, IL 60126 (630) 279-8696

Elmhurst Public Library