Volunteer Form

Please complete this application form if you are interested in becoming a Fond du Lac Humane Society volunteer. Once you complete the form, click the Submit button at the bottom.

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home Phone Number

Please enter a valid phone number.

Cell Number

Please enter a valid phone number.

Email

example@example.com

Note: Volunteers must be a minimum of 18 years of age to volunteer at the Shelter. Under 18 may volunteer at events outside of the Shelter, but must be accompanied by a responsible adult.

Date of Birth

EMERGENCY CONTACT NAME AND NUMBER

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home Number

Please enter a valid phone number.

Cell Number

Please enter a valid phone number.

Why do you want to volunteer

Animal Experience: Please summarize your experience with animals

Limitations: do you have any limitations? Allergies, bending, walking, lifting, ect.

Felonies: Have you ever been convicted of a felony in the last 7 year? (Conviction may not necessarily disqualify you from volunteering. We may conduct a background check, and if you do not provide truthful information you could be rejected or terminated.) Explain:

T-Shirt Size

Schedule Availability:

Please tell us what day(s) you are available to work. Please include morning or afternoon or specific hours.

My availability is weekly or daily?

Start Date of availability

End Date of availability

How much time do I want to volunteer in a week or day?

Volunteer Waiver

As a Fond du Lac Humane Society volunteer, I understand that in caring for said animal(s) I may undertake any number of tasks, including but not limited to:grooming, transporting, feeding, and holding the animal(s). I understand that in assuming this colunteer poistion, I may be exposing myself to potentially significant health risks, including, but not limited to: injuries from bites and scratches. Infectious diseases (e.g. Rabies), parasites (e.g. fleas, worms, ticks, mites, ringworm) and allergic reactions (e.g. skin and asthma). Further, I understand that any of these potential health risks could cause serious medical condition.

Since many animals that come to the Fond du Lac Humane Society are from unknown background and are therefore ultimately unpredictable. I am, thus aware that the Fond du Lac Humane Society is not in a position to know and makes no representatons about the temperament, health or conditon of animal. In particular, I understand that I can not rely on any statements from other volunteers, concering the health and temperament, and that I must rely on my own judgement. I understand and agree that by working with animals as a volunteer is exclusively at my own risk. Therefore, I agree to hold harmless, the Fond du Lac Humane Society, its employee, volunteers agents or directors, whether collectively or individual, for injury or liability the animal(s) may cause to me.

I agree