DL Volunteer Sign Up

Section 1: Contact Information
Name*
First Last
Name Tag Preference*
How do you want your name to appear on a name tag?
Email*
Cell Phone*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Section 2: Availability
Sunday
- Select All
- Morning
- Afternoon
- Evening
Monday
- Select All
- Morning
- Afternoon
- Evening
Tuesday
- Select All
- Morning
- Afternoon
- Evening
Wednesday
- Select All
- Morning
- Afternoon
- Evening
Thursday
- Select All
- Morning
- Afternoon
- Evening
Friday
- Select All
- Morning
- Afternoon
- Evening
Saturday
- Select All
- Morning
- Afternoon
- Evening
Preferred Locations*
- Central Library (Syracuse)
- Onondaga Free Library (Syracuse)
- Maxwell Memorial Library (Camillus)
- Liverpool Public Library
- Dunham Public Library
- Camillus Senior Citizens Center
- Community Library of Jamesville and Dewitt
- Utica Public Library
- New Hartford Public Library
- Kirkland Town Library
- Jervis Public Library (Rome)
- Oneida Public Library
- Sullivan Free Library (Chittenango)
- Frank J. Basloe Library (Herkimer)
- Fayetteville Free Library
- Remsen Public Library
- Beauchamp Public Library
- White Branch Public Library
Available Start Date*
Month
Day
Year
Section 3: Background Information
List any specific digital skills or areas of expertise
Example: Google Apps, Microsoft Office, Data analysis, Training experience, Resume writing, Publisher, Photo editing software, Financial literacy, etc.
Birthday*
MM slash DD slash YYYY
Gender*
Race*
Ethnicity*
Employer/Organization*
Enter N/A for none
Position*
Job title/Retired/Student
Do you have any medical conditions that the Digital Literacy Coordinator should be made aware of?
Section 4: Operations & Confidentiality Policy
Read and check all*
- Select All
- I have received a copy of the Volunteer Position Description and agree to follow the guidelines set forth.
- I agree to volunteer for a minimum of six (6) months (for Fieldwork Students only - the entirety of the semester)
- I understand a typical shift lasts three (3) hours
- I will notify program staff immediately by text, phone, or email if any emergency will keep me from completing an assigned shift
- I will notify program staff of a vacation or other conflict that requires an absence from an assigned shift
Confidentiality Policy: Typing your name below indicates your agreement to follow the terms set below.*
As a volunteer I may have access to the personal information of program customers. I agree that I will never retain, share or otherwise use any personal information of program customers other than to record such information as may be necessary on an online or paper form.
Section 5: Emergency Contact
Name*
First Last
Relationship to Emergency Contact*
Cell Phone*
Address (if different)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Comments
Comments
This field is for validation purposes and should be left unchanged.

Section 1: Contact Information

Section 2: Availability

Section 3: Background Information

Section 4: Operations & Confidentiality Policy

Section 5: Emergency Contact