TLC application

First Name:

Last Name:

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Phone #:

Cell #:

Email Address:

How do you want to be contacted?

Please choose the best way to be contacted.

Text

Phone

School:

Grade:

Age:

Gender:

Male

Female

Prefer not to say

Parent/Guardian Name:

Parent/Guardian Contact #:

In case of emergency, contact:

Please put first/last name, relationship to you and contact #'s.

Are you willing to make a regular commitment to this group?

Yes

What traits and/or skills would make you a good TLC member?

What are some of your hobbies or interests?

What do you like most about the library's current services?

What changes or additions would you suggest to help improve library services to teens?