Volunteer Application

 

Date of Application:

Name: Date of Birth:
Street Address: City:
State: Zip:
Telephone: Email Address:

Have you ever worked for a not-for-profit before? Yes

No

If Yes, Where?


What were your duties there?
Supervisor's Name: Supervisor's Telephone:

Why did you end your service there?

How did you hear about the Humane Society Volunteer program?

Why do you wish to Volunteer here?

Do you have any fears/phobias of animals? Yes No

If yes, which ones?

Will this interfere with your ability to function at the Humane Society? Yes No
Do you have any allergies? Yes No

If yes, to what and do you take medication?

Emergency Contact Name: Telephone:
Relationship to you: Alternate Telephone:

Do you have a Valid Driver's license? Yes No
Are you a student? Yes No

If yes, where?

Have you ever been convicted of a felony? Yes No

If yes, please briefly explain

Are you volunteering for a class? Yes No
Do you plan on volunteering long-term? Yes No

Please check off the areas you are interested in volunteering
Pet Education Pet Therapy
Animal Attendant Volunteer Coordinator Assistant
Special Events    

You may at any time change the area you are volunteering in. See the Volunteer Coordinator for details.

Humane Society of St. Joseph County
2506 Grape Road · Mishawaka, IN 46545
574-255-4726 · info@humanesocietystjc.org
 

Also Found at

PetFinder.com