The Salina Public Library will be closed Monday, Feb. 16 for staff training.

Consent for Release of Reference Information – Minors


    * = Required

    I am the parent or legal guardian of . I understand that my child has volunteered with the Salina Public Library and may request references for employment, educational programs, scholarships, or other opportunities.

    By signing this form, I grant permission for the Salina Public Library to provide general reference information about my child to outside organizations upon request. This information may include, but is not limited to:

    • Dates of volunteer service

    • Number of volunteer hours completed

    • General duties and responsibilities

    • Overall performance, reliability, and conduct while volunteering

    I understand that the library will not disclose sensitive, confidential, or disciplinary information and that providing a reference does not guarantee any outcome related to employment or acceptance.

    This consent remains in effect until the volunteer turns 18 or until it is revoked in writing.

    Authorization

    Type in your name if you agree to the terms above*.