Today's Date:

Name:

Address :

City:

State:

Zip Code:

County of Residence:

Home Phone:

Work Phone:

Date of Birth: (voluntary):

Occupation:

Company Affiliation & address (self):

(spouse)

Education:

Experience (i.e.: public speaking, reading aloud, broadcasting):

Interests:

Church Affiliation (voluntary)

Please specify the volunteer position for which you are applying:

Reader (please indicate shift preference: AM Noon PM Sat. Sun.)
Would you prefer to read at a regular time, or be a substitute reader?

Please indicate the days you would normally be available
Mon Tues Wed Thu Fri Sat Sun

Recorder (Books Short Stories Special Subject

Clerical or Production Assistance
Please list office skills or interests:

Would you like to be involved in Committee Work? (i.e.: Public Relations, Speaker's Bureau, Technical) Y N

If Yes, please identify preferred area of involvement:

Personal Reference:
Name:
Address:
City:
State:
Zip Code:
Phone:
Relationship: _________________

Note: Return the completed application via e-mail to the Triad Information Reading Service at tirs@wfu.edu.