WIN VOLUNTEER APPLICATION
Wildlife In Need Emergency Response of Pennsylvania
What WIN Volunteer Opportunity are you interested in? Check all that apply.
Capture & Transport
Wildlife Courier
Dispatcher
Not Sure
Name:
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth
E-mail
*
example@example.com
Cell Phone Number and Carrier Name (i.e.Verizon, ATT, etc)
*
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Preferred contact method. Check all the apply.
TEXT
EMAIL
CELL PHONE
List Medical Concerns, including Allergies
List two professional references, including contact information and years known.
(For Capture & Transport Applicants Only) Are you vaccinated with pre-exposure rabies vaccine?
YES
NO
NO, but I plan to become vaccinated.
(For Capture & Transport Applicants Only) Have you attended a rabies training program?
YES
NO
What experience do you have with animals?
What experience do you have working with the public via phone or in-person?
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Do you have any special skills or certifications that you feel are relevant to helping WIN?
In general, what days of the week are more available to respond to assignments? (Check all that apply) WIN will work with you to identify your specific availability.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
With respect to the above days of availability, please provide below any guidance you can about hours of availability.
I hereby attest that the above information is true to the best of my knowledge. WIN reserves the right to refuse any applicant and to terminate any volunteer at any time.
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