San Juan del Sur Biblioteca Volunteer Application

Name
Prefix
First
Last
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Address
Street Address
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City
State / Province / Region
Postal / Zip Code
Country
Home Phone

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Mobile Phone

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Work Phone

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Email
Passport Country
Passport Number
Date of Birth

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Emergency Contact
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Relationship
Contact Home Phone

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Contact Work Phone

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Contact Mobile Phone

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Contact Email
I am a:
 High School Student 
 Undergraduate College Student 
 Adult 
 Senior 
Availability from:

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to:

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Please list any physical limitations or health problems:
Why are you seeking this volunteer position:
Areas in which I have experience and would like to volunteer my time:
 Mobile Project 
 Reading Programs 
 Storytime/Crafts Helper 
 Science Project Leader 
 Translation 
 Grant Writing 
 Web Page Maintenance 
 English Language Instruction 
 Adult Programs 
 Young Adult Programs 
 Children's Programs 
 Outreach Programs 
 Technology Training 
 Publication Design 
 Newsletter Editor 
 Fundraising 
 Librarian Training 
 Technology Support 
 Other 
We are always looking for new ideas! If you checked "other" above, please let us know what type of project you are interested in:
Please describe any previous employment, volunteer work, education, special skills, languages or training that you feel is relevant to your interest in volunteering:

Please list two people we may contact as references:

1. Name
Position
Phone
2. Name
Position
Phone
Have you ever been convicted of a crime?
 Yes 
 No 
If yes, please explain the nature of the crime, date, location, and facts:

Applicants are considered for volunteer positions without regard to race, religion, sex, national origin, or disability.

I hereby certify that the information set forth in this application is true and complete to the best of my knowledge. I further under

Type name:
Type date:

Thank you for applying to the San Juan del Sur Biblioteca Movil! If you prefer, you can also print this form and mail it to:

Jane Mirandette
Directora
1716 Del Norte Blvd.
Loveland, CO 80538
USA
If you are in Central America, you can mail the completed application form to:

Jane Mirandette
Directora
San Juan del Sur Biblioteca Móvil
Apartado Postal 17
San Juan del Sur, Nicaragua

We will contact you by e-mail when we have received your mailed application form. Accepted volunteers will be contacted by phone. If you have any questions or concerns, please contact Jane Mirandette at HJHProgram@aol.com or janem101@aol.com.
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