First and Last Name:
D.O.B./Age
Street Address
City:
State:
Zip:
Home Phone:
Work Phone:
Cell phone:
Email Address:
Employer / Profession:
May we contact for reference:
Yes
No
N/A
If yes, please provide name and phone # of employer:
Allergies or physical restrictions:
How did you hear about The Last Resort Rescue?
Why do you want to volunteer at The Last Resort Rescue?
Do you work with any other rescue organizations?
Yes
No
If so, please give contact information for that organization including name and phone #:
Have you worked with wildlife before?
Animal Experience: (check all that apply)
Veterinary Hospital
Boarding Facility
Foster Home
Dog Grooming
Cat Grooming
Shelter Work
Training/Obedience
Pet Sitting
Farm Animals
Wildlife care and Rehab
Horse care
Other
If you would like to comment more on your experience with the above, please do so here:
If you listed other, please explain:
Other Experience, Special Skills, Strengths, Talents: (check all that apply)
Computers
Management
Crafts
Working w/children
Graphic Arts
Woodwork/Carpentry
Painting
Photography
Writing
Secretarial
Fund-raising
Public Speaking
Landscaping/gardening
Other
If you would like to comment more on your experience with the above, please do so here:
If you listed other, please explain:
Volunteer Work Preferences: (check all that apply)
Shelter cleaning
Pet or Wildlife Transport
Dog Walking
Clerical/Office
Foster care (please fill out foster application)
Computer/Website
Special Events
Educational Programs
Community Outreach
Wildlife rehab
Building / construction
Screening applications
Online / social media fundraising
other
When are you available to volunteer? (check all that apply)
Weekdays
Weekends
Would you be willing to volunteer off the shelter premises?
Yes
No
Reference #1 (Name, phone # and relationship to self)
Reference #2 (Name, phone # and relationship to self)
Reference #3 (Name, phone # and relationship to self)
Any additional comments:
In case of emergency, who should we contact? (name and phone #)
This volunteer agreement (“Agreement”) is entered into as of the date set forth below by The Last Resort (TLR). WHEREAS, the Volunteer has voluntarily contacted TLR and has expressed an interest in working with dogs, cats horses, wildlife or other animals in the care and custody of TLR. In consideration of TLR’s agreement to allow the volunteer to view and/or interact with such animals, the volunteer hereby, for his/her heirs, his/her personal representatives, and him/herself represent and warrant as follows: 1. The volunteer is fully aware of the risks that animals pose and have elected to view and/or interact with one or more in the care of TLR voluntarily. The volunteer knowingly assumes all risks that exposure to animals may pose, including but not limited to serious bodily injury and/or death. 2. THE VOLUNTEER HEREBY WAIVES, RELEASES, DISCHARGES, HOLDS HARMLESS, AND PROMISES TO INDEMNIFY AND NOT TO BRING SUIT AGAINT TLR, 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 volunteer has or which may hereafter accrue to the volunteer and from any and all damages which may be sustained by the volunteer directly or indirectly in connection with, or arising out of, the volunteer’s exposure to such animals
By writing your name here, you are agreeing to the above liability waiver.
By writing your name here, you are stating that you are the parent/guardian of the above applicant and you grant your permission for them to volunteer with The Last Resort Rescue.
Anything else you would like to say, please note it here:
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