Volunteer Application

Name *

First Name Last Name

Address *

Street Address

Street Address Line 2

City State

Zip Code

Email

example@example.com

Phone Number *

Area Code Phone Number

What Days are you Available? *

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

What Times are you Available? *

Mornings 8 am - 10 am Mornings 10 am - noon Afternoons noon - 2 pm Afternoons 2 pm - 4 pm Evenings 4 pm - 6 pm Evenings 6 pm - 8 pm Overnight 8 pm - 8 am

Have You Ever Worked at Giles County Animal Shelter? *

Yes No

If yes, when?

Please add Date(s) of Previous Employment

Have You Ever Been Convicted of a Felony? *

Yes No

If yes, please explain

Please provide the felony conviction counts and any probation status

Please Provide Any Previous Shelter Work Experience

Name of Previous Shelter

Street Address Line 2

City State

Zip Code

Phone Number of Previous Shelter

Area Code Phone Number

Types of Responsibilities You Had

List Your Job Responsibilities

Supervisor

Name of Supervisor

May We Call Your Supervisor?

Yes No

Are You a Pet Owner? *

Yes No

Are Your Pets Vaccinations Up to Date?

Yes No

Please Provide Three References

Reference 1 *

Name / Relationship

Company Name / Street Address

City State

Postal / Zip Code

Reference 2 *

Name / Relationship

Company Name / Street Address

City State

Zip Code

Reference 3 *

Name / Relationship

Company Name / Street Address

City State

Zip Code

I certify that my answers are true and complete to the best of my knowledge: *

Clear

In the event you are selected as a Volunteer with the Giles County Animal Shelter, the following Volunteer Agreement is required:

VOLUNTEER AGREEMENT

As a Volunteer with GILES COUNTY ANIMAL SHELTER, I agree to:

• Never strike an animal, or handle or treat an animal in such a way that it would be construed as rough or abusive. I will always exercise compassion and care with the animals.

• Wear appropriate clothing such as closed toe shoes, pants/shorts of an appropriate length, and tops that are free of vulgar/obscene language or images. No flip flops or sandals.

• Donate my services to the GILES COUNTY ANIMAL SHELTER without contemplation of compensation or future employment.

• Carry out my assignments in accordance with training and seek assistance from the Director or Animal Control Officer whenever necessary.

• Communicate any job-related problems, concerns, differences of opinion, conflicts, or suggestions only to Director or ACO.

• Adhere to sign-in and scheduling procedures.

• Notify the volunteer coordinator if I choose to discontinue my volunteer service with the GILES COUNTY ANIMAL SHELTER.

I understand that the GILES COUNTY ANIMAL SHELTER reserves the right to terminate my Volunteer status as a result of the following:

• Any abuse or mistreatment of an animal.

• Failure to comply with organizational policies, rules, and other regulations.

• Unsatisfactory attitude or work ethic

Liability Release & Waiver: I understand that my participation with the GILES COUNTY ANIMAL SHELTER is strictly a volunteer basis. I understand that there are inherent risks associated with my volunteer activities, including the risk of personal injury resulting from animal bites and other animal behavior. In exchange for the GCAS Facility agreement to allow me to participate in its Volunteer Program, I hereby release the MCAS Facility, including its officers, agents and employees, from any and all claims of liability of any kind whatsoever including, but not limited to, claims of negligence and/or injury to me arising out of my participation in the GCAS Volunteer Program. I understand that by signing below I am waiving any and all claims of negligence and/or injury to me, against GCAS, its Officers, Director and employees, arising out of my participation in the GCAS Volunteer Program.

Signature for Volunteer Agreement: *

Clear

In the event you are selected as a Volunteer with the Giles County Animal Shelter the following Release Statement is required:

Release Statement

I, being of lawful age, in consideration of being permitted to participate in the handling of animals, do for myself, my heirs, executors, administrators, and assigns, hereby release and forever discharge the Giles County Animal Shelter, Giles County, TN, their agents, employees, successors, and/or assigns, of and from any and every claim, demand, action or cause of action, of whatever kind and nature, either in law or equity, arising from or by reason of any bodily injury, known or unknown, death or property damage resulting or to animals or any activity in connection therewith at the Giles County Animal Shelter, whether by negligence or not.

I agree to follow all rules and procedures as set forth by the Giles County Animal Shelter and Giles County regarding the care and treatment of animals. I FULLY UNDERSTAND THAT ANIMALS BEHAVIOR IS UNPREDICTABLE AND THEREFORE, I FULLY ASSUME THE RISK OF ANY INJURY ARISING OUT OF MY PARTICIPATION AS A VOLUNTEER.

I also understand if said rules either written or verbal are not followed at the discretion of the Director or Office manager said volunteer may be asked to vacate the premises and may not be permitted to further volunteer.

I further state that I have carefully read the foregoing release and know the contest thereof and signed this release as my own free act and deed.

Signature for Release Statement: *

Clear