Fort Wayne Animal Care & Control Volunteer Application
Please fill out the following form so we can find the best role for you at the shelter.
Full Name
*
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
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Anguilla
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The Bahamas
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Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
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Cook Islands
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Cote d'Ivoire
Croatia
Cuba
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Cyprus
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Democratic Republic of the Congo
Denmark
Djibouti
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Equatorial Guinea
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Faroe Islands
Fiji
Finland
France
French Polynesia
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The Gambia
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Iran
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Kenya
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Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
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Macau
Macedonia
Madagascar
Malawi
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Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Date of Birth
*
-
Month
-
Day
Year
Date
Volunteers must be at least 18 years old - are you over 18 years old?
*
Yes
No
Have you ever been convicted of or pleaded guilty to a felony?
*
Yes
No
Are you willing to submit to a background check including drug screen and police check? Applicants with violent histories, heavy drug/alcohol use, theft, animal abuse/neglect, etc... are not eligible to volunteer.
*
Yes
No
We do not accept volunteers with court ordered community service hours. Is this why you are applying to volunteer?
*
Yes
No
Our organization relies heavily on every volunteer task. Are you able to reliably show up at the same day/time each week?
*
Yes
No
If not, please explain why? School? Work?
To help us know your availability, please indicate what days of the week you are available to volunteer.
Yes
No
Maybe
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
To help us know your availability, please indicate what times you are available to volunteer.
Always
Sometimes
Never
Mornings
Afternoons
Evenings
Weekends
Please list two references that are not family members (name and phone):
*
Please list an emergency contact and their phone number:
*
What animals do you have experience with? (Check all that apply)
Dogs
Cats
Small Animals
Reptiles
Other
What are your past experiences with our organization?
*
Tell us more about your personal experience with animals:
*
Why are you wanting to share your time and talents with Fort Wayne Animal Care and Control?
*
In a short paragraph please tell us a little bit about yourself. What are your talents, hobbies, education, career?
*
How did you learn about volunteer opportunities at Fort Wayne Animal Care & Control?
Facebook
Website
Friend/Family Member
Radio/TV
Newsletter
Other
I certify that the statements made in this application are true and correct and have been given voluntarily. I understand that Animal Care & Control may require me to have a drug screen, that they may do a police background check and I am willing to submit to both. I understand that this information may be disclosed to any party with legal and proper interest, and release Animal Care & Control from any liability whatsoever for supplying such information.
*
I agree
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Part 2: Fort Wayne Animal Care & Control Criminal Check Authorization
Please fill out the following information in order for FWACC to verify volunteering eligibility.
Name as it Appears on Legal Documents
*
First Name
Middle Name
Last Name
Maiden Last Name
Married Last Name
Drivers License Number
*
Drivers License Expiration Date
*
State of Issuance
*
Social Security Number or State Identification Number
*
I hereby authorize Animal Care & Control to obtain information pertaining to any charges and/or convictions I may have had for federal and state criminal law violations. This information will be gathered from any law enforcement agency of this state or any state or federal government, to the extent permitted by state and federal law.
*
Signature
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