Volunteer – Adult Application

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Volunteer – Adult Application

Volunteer Application (Adult)

We love our volunteers! The best volunteers in the world volunteer for us. Thank you for your interest in helping homeless pets and in Pet Harbor Rescue. Our rescue is a nonprofit animal rescue organization for Siberian Huskies & cats. Volunteers with a variety of skills are always appreciated and needed. Please first review our Volunteer Guidelines. Please take the time to complete this application and agreement and return it to us. One application per person. After we receive your application, our Director of Volunteers will jump up and down and shout "Hooray," then add you to our volunteer listserv and welcome you to our ranks. Please direct questions to our Director of Volunteers.

BASICS
Have you read and do you understand and agree to the guidelines?*
- Yes
- No
Have you ever been convicted of a felony?*
- Yes
- No
What charge and when?*
Please list the jurisdiction, charge, date, and sentence for each offense.
Have you ever been convicted of a misdemeanor that involved animals in any way?*
- Yes
- No
What charge and when?*
Please list the jurisdiction, charge, date, and sentence for each offense.
Have you EVER released or returned a pet to an animal shelter, pound, or rescue organization?*
- Yes
- No
Have you EVER given away a pet?*
- Yes
- No
Have you EVER sold a pet?*
- Yes
- No
As a volunteer, privileged and confidential information, such as adopter or applicant contact information, may be released to you for use strictly in the course of your duties as a Pet Harbor volunteer. Do you understand all such information to which you are a custodian may not be divulged to anyone, including other Pet Harbor volunteers, for any reason whatsoever and may only be used for the professional and limited Pet Harbor purpose it was intended?*
- Yes
- No
Do you agree to maintain the highest level of confidentiality of such information and remove it from your possession as soon as you have completed the task for which you were given such information?*
- Yes
- No
Do you understand volunteering has absolutely no influence whatsoever on any adoption decisions and that should you apply to adopt, your adoption application might not be approved?*
- Yes
- No
While representing Pet Harbor, you must espouse Pet Harbor's beliefs and policies, even if they conflict with your own and if you don't know Pet Harbor's stance on something, you must find out before making a statement. For example, if you believe Siberians should be allowed off leash in unfenced yards but know Pet Harbor does not allow that, you must answer a potential adopter's question about it with Pet Harbor's stance, not your own. Do you understand and agree to this?
- Yes
- No
We are happy you are here! How did you find out about us?*
Why do you want to volunteer with us?*
Name*
First Last
Email*
We have a volunteer listserv where we post volunteer opportunities and other information for volunteers. Is the email address you listed above the email address you would like to be included in the listserv distribution?
- Yes
- No
We have an update listserv where we post the updates from our adopters. If you wish to be included in this listserv, is the email address you listed above the email address you would like to be included in the listserv distribution?
- Yes
- No
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Home or Cell Phone*
Whatever number you use most
Work Phone
Occupation
Birth Date*
Month
Day
Year
REFERENCES
Veterinarian Name
Either the name of the doctor or the veterinary practice.
Full Name
Veterinarian Phone
Reference Name
Please choose someone who knows firsthand your character and love for animals.
First Last
Reference Phone
Reference Relationship
Reference Email (if any)
AFFILIATIONS
List your animal organization memberships (if any) with positions held.
If you currently volunteer or have volunteered for or been employed by an animal shelter, pound, or rescue organization, please list the entities.
Have you served on any committees you think would help us in offering you volunteer positions? If so, please list.
Have you chaired a committee or led other pertinent efforts?
- Yes
- No
INTERESTS
Describe areas of animal care-taking, administration, leadership, education, people interactions, etc., that particularly interest you.
Describe areas of animal care-taking, administration, leadership, people interactions, etc., in which you will not participate.
Describe areas of animal care-taking or administrative, leadership, people skills, etc., in which you have particular knowledge or expertise.
What other attributes do you think you can bring to Pet Harbor? For example, if you are a particularly organized person, this is where you tell us.
Which hours and days of the week are you willing to volunteer?
We understand this does not mean EVERY instance. For example, if you write "Saturday morning," we understand that does not mean EVERY Saturday morning.
Do you have allergies to cats or dogs?
- Yes
- No
- Unknown
Please explain.*
Do you have a vehicle you are willing to use to transport pets?
- Yes
- No
Do you have a valid driver's license?
- Yes
- No
Please describe any geographical limitations you have in driving.
Do you currently live with pets (dogs/cats)?
- Yes
- No
Please describe the pets.
Cats? dogs? Spayed/neutered? Breed? Age?
Comments:
Please let us know any other information you wish us to consider in matching you with volunteer tasks. Here is your chance to personalize this application. Information you may think doesn't matter might very well help us match your desires/talents with the right positions.
By indicating yes and submitting this form, I signify that all information given in this application is true and correct, to the best of my knowledge.
- Yes
- No
AGREEMENT*
In consideration of this opportunity to volunteer, I agree to the following terms and conditions, intending to be legally bound by them:

1. I will abide by the mission, rules, regulations, policies, and programs of Pet Harbor Rescue & Referral, Inc. (hereinafter "Pet Harbor") while I am a volunteer.

2. If I discontinue being a volunteer for Pet Harbor for any reason or upon Pet Harbor's request at any time, I will promptly return all of Pet Harbor's supplies, equipment, records, monies, and other items in good, clean condition.

3. I assume the risks of being bitten, scratched, injured, or frightened by cats, kittens, dogs, and puppies in connection with my volunteer work for Pet Harbor. Pet Harbor is not liable to me for any injuries, damages, liabilities, losses, judgments, costs, or expenses whatsoever which I might suffer or sustain in connection with the performance of my volunteer activities for Pet Harbor unless they are the result of Pet Harbor's gross negligence or intentional misconduct. I will indemnify, defend, and hold Pet Harbor harmless from and against any claims, lawsuits, injuries, damages, losses, costs, or expenses whatsoever sustained by any companion animal or any person in connection with my intentional misconduct or grossly negligent performance of volunteer activities for Pet Harbor or my breach of Pet Harbor's rules, regulations, policies, and programs.

4. I understand and agree that Pet Harbor may refuse volunteer applications for any reason.

5. I have accurately and truthfully completed this volunteer application and agreement.

6. Any modification to this agreement must be in writing signed by both parties. This agreement is binding upon me and my respective heirs, successors, assigns, executors, and personal representatives.
- Yes, I agree.
- No, I do not agree.
Comments
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Volunteer – Adult Application

Volunteer Application (Adult)

BASICS

REFERENCES

AFFILIATIONS

INTERESTS

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