Volunteer Application

   
Name:

    _______________________________________________


Are you over the age of 18?

    ____ Yes
____ No


If you are under the age of 12 you must have a parent or guardian with you when you volunteer.  

   
If you are under the age of 12 please list the name of your parent/guardian that will be your supervisor.

    _______________________________________________

_______________________________________________


Address:

    _______________________________________________

_______________________________________________

_______________________________________________


Home Phone:

    _______________________________________________


Work Phone:

    _______________________________________________


Cell Phone:

    _______________________________________________


Email:

    _______________________________________________


Employer/School:

    _______________________________________________


Occupation:

    _______________________________________________


How do you prefer to be contacted?

    ____ Home
____ Work
____ Cell


Emergency contact person:

    _______________________________________________


Phone #:

    _______________________________________________


Medical restrictions:

    _______________________________________________

_______________________________________________

_______________________________________________


Have you had a tetanus shot within the past seven years?

    ____ Yes
____ No


I hereby authorize the Humane Society of the Lakes (HSL) to seek emergency medical treatment in case of accident, injury, or illness.  By participating in the HSL volunteer program, I agree to hold harmless the Humane Society of the Lakes and any employee and/or member of the Board of Trustees of said agency from any liability arising in conjunction with my participation in a HSL volunteer program.

    ____ Yes
____ No


Name and Date:

    _______________________________________________


Parents name and date:
(Required for volunteers under 18 years of age)

    _______________________________________________


How often would you like to volunteer:

    _______________________________________________

_______________________________________________

_______________________________________________


Which days/hours would you be available:

    _______________________________________________

_______________________________________________

_______________________________________________


Would you be available for weekends/holiday?  Please list which ones:

    _______________________________________________

_______________________________________________


Please note which opportunities you would like to work

   
Current Fundraisers/Events:

    ____ PetSmart Adoption Days
____ Santa Photos
____ WeFest
____ Tuxes & Tails
____ Irish Fundraiser
____ Shelter Fest
____ Annual Water Carnival Parade


Volunteer Opportunities at the Shelter:

    ____ Kennel Crew Dog
____ Kennel Crew Cat
____ Canine Companion
____ Feline Friend
____ Office Support
____ Groomer
____ Shelter Cleaning
____ Shelter Maintenance
____ Groundskeeper
____ Animal Transporter
____ Donation Pick-Up
____ Evacuation/Disaster Team
____ Foster Home for Dogs or Cats


This institution is an equal opportunity provider and employer.