Refuge Rescue Volunteer Application

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Your Personal Information

* First name

* Last name

* Email

* Phone

Cell number

* Current Address

Current Address 2

* Zip

* City

* GenderMaleFemale

Country

*State/Province

Date of Birth

* Month

* Day

* Year

Additional Information

Driver’s License Number:

Driver’s License State

Auto Insurance Information (required for transportation):

Emergency Contact/Phone:

Please check which activities you would like to help with:

FosterTemp FosterTransport pets from shelters/kennel to vet officesTransport pets to and from adoptionsAdoption Event AssistanceEducation and Community Outreach Advertising/Marketing/PR WorkAdministration WorkCleaning CrewPet PhotoshootsFundraisingGroomingTrainingOther

AVAILABILITY: please check all that apply

Sunday AMSunday PMMonday AMMonday PMTuesday AMTuesday PMWednesday AMWednesday PMThursday AMThursday PMFriday AMFriday PMSaturday AMSaturday PM

How did you hear about us?

Have you ever been convicted of a misdemeanor or felony?

YesNo

If yes, please explain:

Are you 18+ years old?

YesNo

If under 18, do you have a parent’s permission to volunteer?

YesNo

Parent Signature:

Certification

Application Agreement

I hereby certify all of the information I have given is true and complete.

ORGANIZATION INFORMATION:

Our Policy It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability. Refuge Rescue Agreement and General Release for Volunteers: By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. I agree that I am providing volunteer services to Refuge Rescue of my own free will. I understand that Refuge Rescue is not responsible for any illness or injury caused by any animals I come into contact with during my volunteer work. I agree to hold harmless and release from liability Refuge Rescue should I become sick or injured from any animals as a result of my volunteer work.

Signature of Applicant:

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