Volunteer Application

Personal information on this form is collected under the authority of the Public Libraries Act, R.S.O. 1990, c P.44 and will be used to
select volunteers for the Mississauga Library System. Questions about the collection of this personal information should be directed
to the Freedom of Information Co-ordinator, Mississauga Library, 301 Burnhamthorpe Road West, Mississauga, ON L5B 3Y3,
905-615-3200, ext. 3601.

Note: Only those persons who are 14 or older are eligible to be volunteers with the City of Mississauga
Please Print
__________________________________________
Hung
Last Name

_______________________________________________
Osman
First Name

Address: ____________________________________________________
265 Huntington Ridge Drive
(647)873-1051
Home Phone: ___________________________________

Postal Code: ___________________

L5R 1R8

N/A
Business Phone: _____________________________

Osmanhung1@gmail.com (best way to contact)

Email Address ________________________________________________________________________________

Occupation (please indicate if you are a student*) ____________________________________________________

Student
*Students who require volunteer hours as part of the Community Service Program, please indicate:
Nov. 28, 2015
in Sept.
Prefer ~40hrs
Grade: 12
____________
Number of hours required ______________
and by what date: ______________________

Lego Competitions Co-ordinator (PTSC, FLL), Piano & music theory teaching assistant,
Volunteer Experience: _________________________________________________________________________
Salvation Army Thrift store volunteer
Employment Experience: ________________________________________________________________________
Interests in music (piano), math. Can speak English fluently, and Cantonese
Interests, Languages Spoken, Special Skills: _______________________________________________________
& French secondarily
Available for
Volunteer Work

MON

TUES

WED

THURS

FRI

SAT

Morning

Afternoon

Evening

CLOSED

1) Mississauga Central Library, 2) Frank McKechnie Library

Preferred Library Location: _______________________________________________________________________
Only those applicants being considered for a placement will be contacted. This application will be kept on file for
six months.
Have you ever been convicted of a criminal offence for which a pardon has not been granted?
X
Yes ___________ No ____________
I acknowledge and understand that if I am successful in obtaining a volunteer placement, the placement is conditional
upon my completing a Record of Offences Declaration that is acceptable to the City of Mississauga.
Signature of Applicant: _______________________________________________ Date: ______________________
For Office Use Only:
Manager's Signature: __________________________________ Effective Date: ____________________________
Location: _____________________________________