Volunteer Application form

Full Name

First NameLast Name

Are you over age 18?

Please provide birth date

must be at least 14 years old

E-mail

Do you check your email daily?

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number - Home

Area CodePhone Number

Phone Number - Cellular

Area CodePhone Number

Do you use texting?

Phone Number - Work

Area CodePhone Number

Are you allergic to animals?

Please explain

Do you have a driver's license & access to a vehicle?

Have you ever been convicted of animal abuse or neglect?

Are you volunteering to fulfill a requirement?

Please explain

Why do you want to volunteer?

Do you have pets of your own?

What kind?

Days you are available to volunteer

Volunteer positions you are interested in filling:

Other

Disclaimer: As a CatNIP volunteer, I am fully aware that I could receive a scratch, bite and/or any
other injury from the animals that I am caring for, or that I could be injured by an accident not related
to the animals. Therefore, I will not hold the CatNIP organization, including CatNIP’s directors and
officers, nor any host stores, responsible for any scratches, bites and/or any other injuries that occur
while I am on the premises where I am caring for the animals or any other services for CatNIP.

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I certify that the above information is correct, and I understand that the information will be verified.

Please allow several days for processing.

Date

MonthDayYear

By typing your name below, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application.

Your name

Parent or Guardian name