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VOLUNTEER APPLICATION 
Court-Ordered ervice  
CONTACT INFORMATION 
Name (Ms/Mrs/Miss/Mr/Dr/Rev):
 
Street Address:
 
City, State, ZIP:
 
E-mail address:
 
Daytime Phone:
 
Evening Phone:
 
Birth Date
(
if you are under 21
)
Organization requiring community service:
 
Organization address:Organization contact person: Contact phone number: Contact email:
 
Hours needed: Deadline, if applicable:
CRIMINAL HISTORY INFORMATION 
 
(required) 
What was the date and nature of your offense?Comments:
DETAILS & AVAILABILITY 
1
st
Preferred Library: 2nd Preferred Library:Please indicate your availability
(check all that apply): 
ShiftMonTueWedThuFriSatSunM – 1 PMM – 5 PM5 PM – 9 PM
Comments:
Volunteer Application for Individual ServicePage 1 of 2
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