Spring 2013 Reading Buddies Volunteer Application

1. Please PRINT clearly!

2. Thank you for your interest in the Reading Buddies/Writing Buddies program!

3. Students in grades 7 - 12 may apply. (Sixth graders should contact the coordinator for the "Big Buddies in Training" application)

4. Gender*
   1. Male

   1. Female

5. Age*

6. Graduation Year

7. School*

8. First Name*

9. Last Name*

10. Street Number*

11. Street Name*

12. Street Type

13. Apt #

14. City*

15. State*

16. Zip*

17. Email Address*

18. Home Phone*

19. Cell phone

20. Daytime phone number where parent/guardian can be reached in case of emergency*

21. Parent/guardian name*

22. Parent/guardian email

23. Why do you want to be part of Reading Buddies? What are your goals as a Big Buddy?*

24. What are some of your favorite things (books, activities, school subjects, etc.)?*

25. I am available for the following (check all that apply):*
    1. Program at Sanchez Elementary, Mondays 3:40-4:55, 1/28 through 4/22 (no meeting on 2/18, 3/25, and 4/1)
    2. Program at Lafayette Public Library, Tuesdays 4:00-5:15, 2/4 through 4/30 (no meeting on 2/19 and 3/26)
    3. Program at Lafayette Public Library, Saturdays 10:15-11:30, 2/2 through 4/27 (no meeting on 3/23 and 3/30)

26. If you are available for more than one program, would you like to:
    1. participate in the ONE program where Big Buddies are most neeeded
    2. participate in the two programs where Big Buddies are most needed

27. Please indicate any dates you know you will not be available:

28. Which language would you prefer to use with your Little Buddy?*
    1. English
    2. English and Spanish
    3. English and another language

29. READING BUDDY APPLICANT INTERVIEWS (for new Big Buddies only) will be conducted in January. Please indicate below which days you are available; we will contact you to set up a specific interview time. Interviews are 15 minutes; a parent is required to attend the first five minutes of the interview.
    1. Tuesday, 1/8 (afternoon-early evening)
    2. Monday, 1/14 (afternoon-early evening)
    3. Tuesday, 1/15 (afternoon-early evening)
    4. Thursday, 1/17 (afternoon-early evening)

30. TRAINING: Mandatory for new Big Buddies; choose one. If you have already attended a Big Buddy training, please consider attending to help out and share your experience!*
    -- Select One --I will attend training on Saturday, 1/19, 10am - 1pm, lunch provided.i will attend training on Tuesday, 1/22, 4-7pm, dinner provided.I have already attended a BB training, and will not attend one.

31. SUBSTITUTING: I am available to sub for other BBs, when contacted in advance. Check all that apply, if interested:
    1. Mondays
    2. Tuesdays
    3. Saturdays

32. Assistant Coordinators: Returning BBs only, 9th grade and above; see the brochure or website for more information about this position.
    1. I am interested in serving as an Assistant Coordinator; please send me the short, follow-up application for this position.

33. Applicant: Please initial the following statements and sign below:*
    1. I am aware of the dates and requirements of the program. I will arrive on time and contact the Reading Buddy Coordinator and my Little Buddy in advance if unable to attend a meeting.
    2. I agree to participate in ALL aspects of the program to the best of my ability, and read the Big Buddy Handbook, before attending the training or meeting my Little Buddy.
    3. I will adhere to the library's volunteer guidelines and model appropriate, respectful behavior in the library for the younger children.

34. Parent/Guardian, please initial the following statements and sign below:*
    1. I am aware of the dates and requirements of the program.
    2. I will encourage my child to be a caring, reliable, resourceful, and creative Big Buddy.

35. Parent/Guardian, please initial this Photo Relase ONLY if you authorize us to include pictures of your child in Library publicity.*
    1. I give the Library permission to publish in print or electronically the likeness/image of my child.
    2. I release all claims against the Library with respect to copyright ownership and publication, including any compensation claim related to the use of the materials.

Leave This Blank:


36. 1. Receive email copy
37. Email address

38. Submit

* indicates a required field