Volunteer Application

Volunteer Application
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Occupation*
Availability

Weekday MorningsWeekday EveningsWeekend MorningsWeekend Evenings
Interests

Feeding, Cleaning & Socializing (FCS)Special Events/FundraisingTransportation (typically to and from vet appointments)Adoption CounselorFosterOther
Special Information: All volunteers must be at least 18 years of age*
Date of Birth
Most Recent Tetanus Shot *
(Date if possible mm/yyyy)
Have you had Pre-Exposure Rabies Vaccinations?*

YesNO
Special Skills or Qualifications: Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.*
Reason for Volunteering: Summarize your previous volunteer experience.*
Person to notify in case of emergency:
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Agreement & Signature
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty: