Everett Roehl Marshfield Public Library Volunteer Form

Thank you for your interest in supporting the Marshfield Public Library volunteer program. Please complete the following questions.

Contact Information:

First Name:

Last Name:

Address:

Address Line 2:

City/Town:

State:

Primary Phone:

Secondary Phone:

Email:

Birth Date:

Availability (check all that apply):

MorningsEveningsWeekendsOther

If Other Please Add Availability Here.....

Do you have any physical limitations or medical conditions we should consider in job assignment?

Emergency Contact

First Name

Last Name

Relationship

Phone