Volunteer Application Form

Volunteer Application Form
Today's Date*

MonthDayYear
Date
Name*

First NameLast Name
Phone Number*
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birthday*

MonthDayYear
Date
YOUR OCCUPATION
Company Name*
Your Title*
Do you own a dog or cat?*

YesNo
What is the animal's name?*
Is your pet up to date on vaccines & prevention?*

YesNoI'm unsure
What is your vet's name?*
What is your vet's phone number?*
Please enter a valid phone number.
What is your vet's address?

OPEN ENDED QUESTIONS
Why do you want to volunteer at Speak! for the Unspoken?*
Have you volunteered at an animal rescue before? If yes, please elaborate on your role.
Please list any special skills or qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.

REFERENCES

References cannot be a relative, house mate, or significant other.
Reference #1 (References cannot be a relative, house mate or significant other)
Name*

First NameLast Name
What is their relation to you?*
Phone Number*
Please enter a valid phone number.
E-mail*
example@example.com
Reference #2
Name*

First NameLast Name
What is their relation to you?*
Phone Number*
Please enter a valid phone number.
E-mail*
example@example.com

POLICY & AGREEMENT
All information I have provided is true and complete to the best of my knowledge. I understand the purpose of Volunteering is to support the Speak! for the Unspoken organization (Speak!) and its mission. Speak! reserves the right, at its sole and absolute discretion, with or without reason, to decline or accept my application. I understand that I may be contacted by Speak! for a phone interview and home visit before my application to foster or volunteer is approved. Should I be approved to serve as a foster home, I agree that the foster animal will reside in my home. I agree to provide the animal with adequate food, water, shelter, attention and medical care. By signing this application, I consent to a public background search and agree to supply any further information required to complete the processing of this application. Speak! will accept the donation of my time, effort, and services subject only to my agreement as contained in this Waiver. I wish to donate my time, effort, and services to assist Speak! in its care of animals. I recognize and understand the inherent risks associated with the care of animals, including but not limited to the possibility of any injury to myself, other persons and/or property which I may suffer because of the unpredictable nature and/or provocation of animals. I agree to indemnify and hold harmless Speak!, its officers, directors, volunteers, and agents from any and all liability arising out of or in consequence of any injury sustained as a result of any activity connected with fostering animals or volunteering for Speak! This Waiver shall be binding upon the parties to this agreement, as well as their heirs, assigns, agents and legal representatives. I agree to the above waiver of liability upon submission of this application.
Applicant Name*

First NameLast Name
Signature*

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Volunteer Application Form

INTERESTS & AVAILABILITY

OPEN ENDED QUESTIONS

REFERENCES

POLICY & AGREEMENT