TECH Lab Mentor Application
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Name *
Mailing Address *
Phone Number *
Email Address *
Birthday *
MM
/
DD
/
YYYY
Social Security Number *
Are you currently employed? *
If yes, where?
Are you currently enrolled in school? *
If yes, where?
What year are you currently enrolled in?
Clear selection
What is your major?
List any minors you may have
Emergency contact *
Please list name and phone number
How did you hear about the TECH Lab Mentor Program? *
The TECH Lab is open Monday-Thursday, 2:30-5:30 pm and Friday, 12:30-5:30 pm. (Days and Hours may change). Will you be available to mentor at least one day per week for three hours during the times listed? *
Please list 2 personal and/or professional references. *
Name, Phone Number, Relationship
Please list all technology or art that you have experience with (ex. resume building, writing, knitting, digital photography/videography, music, engineering, computer programming, etc.) and what level of experience you have. *
What personal and/or professional goals prompted you to apply to be a mentor? *
What experience do you have working with teens and/or youth? *
Have you ever been arrested and/or convicted of a crime? *
If yes, for what?
Please include where and when.
As an applicant for a volunteer position with Billings Public Library, I hereby expressly authorize release of any information you, as a reference, may have concerning me, including information of a confidential or privileged nature. I hereby release any organization, company, institution or person furnishing the information requested. I authorize the use of duplicated copies of this document to serve as the original. *
Required
For the purpose of in-house security, I consent to a criminal history check, background investigation and drug screening prior to employment. *
Required
I certify that the foregoing answers, and all supplement documents, are correct and that false information may result in denial and/or dismissal. If offered a volunteer position, I will abide by the Policies, Practices and Procedures of Billings Public Library and the City of Billings. *
Required
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