Intern Animal Rescue Application Form

First and Last Name:
Date of birth
Must be 18 or older
Street Address
City:
State:
Zip:
Home Phone:
Work Phone:
Cell phone:
Email Address:
Allergies or physical restrictions:
How did you hear about Second Chance Animal Rescue And Sanctuary?
Why do you want to be an intern here?
Have you worked with any other rescue organizations?

Yes No
If so, please give contact information for that organization including name and phone #:
Please list any pets you currently own (or have owned in the past).
Animal Experience: (check all that apply)

Veterinary Hospital Boarding Facility Foster Home Dog Grooming Cat Grooming Shelter Work Training/Obedience Pet Sitting Farm Animals Other
If you would like to comment more on your experience with the above, please do so here:
Are you only interested in working with the animals or can you do office work as well?
Other Experience, Special Skills, Strengths, Talents: (check all that apply)

Computers Management Working w/Special Needs Animals Graphic Arts Photography Writing, Pet Adoption Description Secretarial Fund-raising Good With People Other
If you would like to comment more on your experience with the above, please do so here:
What do you think sets you apart from others applying for this Intern position?
Volunteer Work Preferences: (check all that apply)

Shelter cleaning Pet Transport Animal care ( Feeding, Walking, Administering Daily Meds) Clerical/Office Computer/Website Special Events Educational Programs Community Outreach Other
What is your availability?

Monday Tuesday Wednesday Thursday Friday Saturday Sunday
What Times Are you Available? State Day And Time (Hours Of Operation 8-5)
Reference #1 (Name, phone # and relationship to self)
Reference #2 (Name, phone # and relationship to self)
Any additional comments:
In case of emergency, who should we contact? (name and phone #)
This Intern agreement (“Agreement”) is entered into as of the date set forth below by Second Chance Animal Rescue And Sanctuary (SCARS). Whereas, the Intern has voluntarily contacted SCARS and has expressed an interest in working with animals in the care and custody of SCARS. In consideration of SCARS'S agreement to allow the Intern to view and/or interact with such animals, the Intern hereby, for his/her personal representatives, and him/herself represent and warrant as follows: 1. The Intern is fully aware of the risks that animals pose and have elected to view and/or interact with the animals in the care of SCARS. The Intern knowingly assumes all risks that exposure to dogs/cats may pose. 2. THE INTERN HEREBY WAIVES, RELEASES DISCHARGES, HOLD HARMLESS, AND PROMISES TO INDEMNIFY AND NOT TO BRING SUIT AGAINST SCARS, its directors, officers, volunteers, staff, and all other agents, and attorney for any of the referenced parties and any other parties acting for or on behalf of the referenced partied from an and all rights and claims which the intern has or which may hereafter accrue to the intern and from any and all damages which may be sustained by the intern directly or indirectly in connection with, or arising out of, the intern’s exposure to such dogs.

SCARS takes measures to help ensure the safety of its staff/interns/volunteers that interact with the animals, But just as a precautionary warning, things can still happen.
By writing your name here, you are agreeing to the above liability waiver.
Anything else you would like to let us know, please note it here:
Upcoming Vacations/Days You Wont Be Able To Come In etc...
Should be Empty:

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