Volunteer Application Broward County Page 2
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PARENTAL PERMISSION FOR VOLUNTEER
(Required for applicants under the age of 18 years)
Volunteer’s Name: ________________________________________ Date of Birth: _________
(Last)
(First)
Address: _____________________________ City: ____________________ Zip:__________
Name of
Parent/Guardian: ______________________________________________________________
Home Phone: ________________________________ Work Phone: _____________________
E-mail Address: ______________________________________________________________
CONTACT IN CASE OF EMERGENCY
_________________________
_____________________
___________________
________________
Name
Relationship
Home Phone
Work Phone
_________________________
_____________________
___________________
________________
Name
Relationship
Home Phone
Work Phone
VOLUNTEER ASSIGNMENT
Library Location: ______________________________________________________________
Hours/Days: _________________________________________________________________
Method of Transportation: _______________________________________________________
PARENTAL PERMISSION
My son/daughter/ward ________________________________ has my permission to participate
in the volunteer program at the following library location _______________________________.
I am aware of my child’s schedule, possible volunteer job duties, and expected rules of behavior
and am in accordance with them.
My son/daughter/ward has my permission to sign the Request for Criminal Background
Information (Form V2), which authorizes Broward County to conduct the required criminal
background screening.
______________________________________________
____________________
Signature of Parent/Guardian
Date
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