WARRICK HUMANE SOCIETY

VOLUNTEER APPLICATION

Volunteers must complete this application and participate in an interview before you begin working at Warrick Humane Society. Volunteers accepted into the program must complete the orientation and training session. Someone from WHS will contact you after you submit this application to set up a time and date. Print this form, fill it out and  bring it with you to Warrick Humane Society. Business hours are Tuesday-Saturday, noon-4 p.m.

Thanks for Sharing your time with us.

 

Please print clearly.

Today's Date ________________

Name ________________________________________________________________________Date of Birth (day/month/year ___________________

Address ________________________________________________________ City ___________________________________ Zip: __________________

Email address that you check often, because that's how we prefer to communicate with volunteers ______________________________________________

Home phone _____________________________________ Work phone ____________________________________ Cell Phone ____________________________

May we contact you at work? ___

Driver's license number if you have one ____________________________________________ Are you willing/able to transport animals? __________

Do you have any known allergies or physical conditions that would affect your volunteer work? ____ If so, please describe and tell us what you are able to do. _____________________________________________________________________________________________________________________________

In case of emergency, please nofity:

Name _______________________________________________________________________________Relationship to you _________________________________

Address _____________________________________________________________ City _______________________________________________ Zip ____________

Phone numbers to call to reach emergency contact: _________________________________________  ____________________________________________

Are you employed? _________  If so, please state your occupation and your place of employment. ____________________________________________

_______________________________________________________________________________________________________________________________________

Do you have any skills or do you work in a profession taht would be beneficial to the animals? For example, are you a groomer, in the media industry, do carpentry, office work, computer tech, janitorial services, etc.  _______________________________________________________________

 

In what ares would you like to share your time and what would you find most rewarding?________________________________________________________

__________________________________________________________________________________________________________________________________________

 

How many hours per month can you volunteer and when are you available? ___________________________________________________________

When are you available for orientation and training? _________________________________________________________________________

Can you phone volunteers to help staff special events, etc.? ______________

                                                                           

                        VOLUNTEER AGREEMENT

 

• As a WHS volunteer you will be required to abide by the terms of a volunteer agreement. The agreement below details what the WHS will expect of you and what you can expect from the organization.
• If accepted as a WHS volunteer, my signature below indicates that I have read, understand and agree to the following: 
• I will abide by all WHS policies and procedures.
• I understand that WHS is a facility that euthanasia is used when deemed necessary, if an animal is injured, aggressive or ill.
• I agree to be supervised by the Managerof the Volunteer Program or designee and will directly report to the Manager of the  Volunteer Program with any problems that arise.
• I agree to work the hours agreed to set up in the program, unless I am terminated from the program.  If I am unable to fulfill my regularly scheduled hours, I will provide advance notice to the volunteer coordinator and arrange for rescheduling.
• I authorize the WHS to seek emergency medical treatment for me in case of accident, injury or illness.
• I agree not intentionally place any animals in a situation that will be harmful or detrimental to their well-being.
• I hereby agree to release, indemnify and hold harmless the WHS, its officers, directors, employees and agents from any and all claims, damages, and liability arising from or related to my activities as a WHS volunteer, under this agreement or for any negligent act or omission by the WHS, it officers, directors, employees, and agents.  In connection with my activities as a WHS Volunteer, I further agree to release, hold harmless, and indemnify the WHS, its officers, director, employees and agents, from any and all claims, damages and liability arising from riding as a passenger in any motor vehicle owned or leased by the WHS and operated by an employee or authorized agent.

 

Signature: ________________________________ Date: _________________________

 

If under 18 years of age, Parent’s Signature: ____________________________________

 

Print Names(s) here  (V)  __________________________  (P) ____________________