Host Registration Form

If you are interested in being a host library for the job shadowing program, please fill out the form below. SCLS staff will contact you when a potential visitor has expressed interest in visiting your library. With your approval, we will give the visitor your contact information; it is the visitor's responsibility to get in touch with your designated contact person to schedule a time for the visit.

Contact Person at Library: *

Job Title: *

Library/Organization: *

Street Address: *

City: *

Email: *

Work Phone: *

Type of special library:

Type of library:

Type of programming for the public: Adult
Youth

Please list other areas of interest:

Tell us about any special projects, special subject areas, or experiences which you think would make a good job shadow experience:

Length of time you are willing to spend with visitors: * 2 hours
4 hours
6 hours

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