Sonflower Ranch Wildlife Rehabilitation Center Volunteer Application

Wildlife Rehabilitation Center Volunteer Application

15455 Powhaton Rd, Brighton, CO 80603
Date

Month Day Year
Date
Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Mailing Address, if different

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Cell

Area Code Phone Number
Text OK?

Yes No
Home Phone

Area Code Phone Number
Work Phone, if applicable

Area Code Phone Number
Email
example@example.com
Current Employer, if applicable. Please fill in blanks.
Position Organization Part-time Full-time Supervisor Employer Phone Employer email Street AddressAddress Line 2 City State Zip
OK to contact? Yes No
How did you hear about SFR Wildlife Rehabilitation Center?
Why are you pursuing volunteer work at SFR Wildlife Rehabilitation Center?
What area(s) of volunteer work are you interested in (please check all that apply)?

Fundraising Animal Care (feeding, cleaning, enrichment, etc.) Cleaning (cleaning outside cages, laundry, etc.) Maintenance (such as cage building) Animal Transport Community Outreach/Education In-kind donations Administrative assistant Other Administrative (contact database, thanking donors, maintaining records, etc.)--possible home-based PR/Marketing--possible home-based Responding to phone inquires--possible home-based Volunteer coordinator--possible home-based Newsletter --possible home-based
Skills/Experience, if any, in areas of interest
Number of hours per week able to volunteer
Do you have rabies vaccine documentation or are you willing to acquire the vaccine at your own cost (required for direct animal work with rabies-vector species, such as raccoons)?

Yes I have the vaccine and documentation No, I don't have but am definitely willing to get No, I don't have but may be willing to get No, I don't have and am not willing to get/not interested in direct animal care with rabies-vector species
Previous volunteer work, if applicable.
Position Organization Contact/Supervisor Phone Number Email Street AddressAddress Line 2 City State Zip Dates of Service
OK to contact? Yes No
Describe previous volunteer responsibilities
Limitations that may require consideration (medical, family, seasonal schedule) Please describe conditions that may require special attention such as asthma, allergies or other (include information regarding epi-pen, inhaler, etc.)
Please include two personal references who are not family members or part of your household:
Reference #1 Name

First Name Last Name
Reference #1 Phone

Area Code Phone Number
Reference #1 Email
example@example.com
How long have you known this person?
Reference #2 Name

First Name Last Name
Reference #2 Phone

Area Code Phone Number
Reference #2 Email
example@example.com
How long have you known this person?
Please include an emergency contact

First Name Last Name
Emergency Contact Phone Number

Area Code Phone Number
Additional Emergency Contact Phone Number, if applicable

Area Code Phone Number
Relationship
When are you free to begin volunteering at SFR Wildlife Rehabilitation Center?
I understand that I must be 18 years of age to volunteer at SFR Wildlife Rehabilitation Center (volunteer projects are available for volunteers under age 18). I also understand that volunteer work at SFR Wildlife Rehabilitation Center may involve physical hazards and I enter into this involvement at my own risk. SFR Wildlife Rehabilitation Center may request a change in my volunteer assignment based on standards of safety and productivity required by the business or deemed appropriate in their estimation. They may also request that my service be terminated for the same reasons. I also affirm that my tetanus shot is up-to-date and will provide this information upon request of SFR Wildlife Rehabilitation Center.

I also herby certify that information provided on this form is accurate and honest to the extent of my knowledge.
Signature

Clear
Date

Month Day Year
Date
Should be Empty:

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