Volunteer Application Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Email is the primary means of communication. If you do not have an email address, please let us know. Can you commit to a minimum of 6 months at the Animal Protection Center? * Yes No Are you at least 18 years of age? * Yes No Do you work? * Full Time Part Time Unemployed Retired Occupation * Please list your job title and employer's name. Education * Please select all that apply. High School College Graduate Are you currently a student? * Yes No If so, please list school and major. Is this volunteer application for the completion of a school requirement or court-ordered community service? * Yes No If so, please comment. Have you ever been convicted of a felony? * Yes No CORI Check Consent: APCSM conducts Criminal Offender Record Information (CORI) checks on all volunteers. Do you consent to a CORI check as part of your volunteer application process? * Yes, I consent to a CORI check No, I do not consent to a CORI check Do you have a valid driver's license? * Yes No Do you have a reliable form of transportation? * Yes No Do you have any health concerns? * Please include any allergies. Yes No Are you covered under health insurance? * Yes No If so, please list provider. If not applicable, state N/A. * Please list any special training, certifications, education relating to animal care/welfare. * Please be specific. Please list your previous volunteer experience. * Please be specific. Do you have pets of your own? * Yes No If so, please list. * Include name, age, breed, sex. Why would you like to volunteer? What do you want to gain from this experience? * Please be specific. Please check all volunteer jobs that are interesting to you. * If you are looking to foster, please fill out the designated foster care application located on our website. General Help Dog Cleaning Cat Cleaning Smalls Cleaning Events Transportation Open Houses Grant Writing Bake Sale The AM General Help shift occurs between 9 - 11 AM, with room for flexibility. Please indicate which days you are available for this shift. Please check all that apply. If you are not interested in this task, please skip this question. Monday Tuesday Wednesday Thursday Friday Saturday Sunday Cat cleaning shifts occur from 9 - 11 AM. Please check which day(s) you are available for cat cleaning. Please check all that apply. If you are not interested in this task, please skip this question. Monday Tuesday Wednesday Thursday Friday Saturday Sunday Dog cleaning shifts occur from 9 - 11 AM. Please check which day(s) you are available for dog cleaning. Please check all that apply. If you are not interested in this task, please skip this question. Monday Tuesday Wednesday Thursday Friday Saturday Sunday Smalls cleaning shifts occur from 9 - 11 AM. Please check which day(s) you are available for smalls cleaning. Please check all that apply. If you are not interested in this task, please skip this question. "Smalls" include guinea pigs, rabbits, birds, hamsters, and sometimes rats, mice, chinchillas, and ferrets. Monday Tuesday Wednesday Thursday Friday Saturday Sunday Mid-day dog walks occur between 12:30 - 2 PM. Please check which days you are available for mid-day dog walks. Please check all that apply. If you are not interested in this task, please skip this question. Monday Tuesday Wednesday Thursday Friday Saturday Sunday The PM shift occurs between 4 - 6 PM, with room for flexibility. This shift entails both dog walking and general help. Please check which days you are available for this shift. Please check all that apply. If you are not interested in this task, please skip this question. Monday Tuesday Wednesday Thursday Friday Saturday Sunday Open houses occur on Tues, Thurs, Fri, Sat & Sun from 1 - 4 PM. Please check which days you are available. Please check all that apply. If you are not interested in this task, please skip this question. Tuesday Thursday Friday Saturday Sunday Please check which days you are available to help with events. Please check all that apply. If you are not interested in this task, please skip this question. Weekday mornings Weekday afternoons Weekday evenings Weekend mornings Weekend afternoons Weekend evenings Group tours occur on various days and times and can be scheduled based on your availability. Please indicate when you are available for tours. If you are not interested in this task, please skip this question. Do you have any questions for our staff? Emergency Contact Name * Emergency Contact Phone Number * (###) ### #### Relationship * Emergency Contact Please read: Due to the size of the adoption center, we CANNOT accommodate all applicants. Volunteer positions are filled based on shifts available at the adoption center. We DO NOT offer any short-term community service opportunities. Also, we CANNOT consider incomplete, illegible applications, nor can we consider applicants that do not meet our minimum age requirement of 18. You will be contacted for a meeting if your application meets our shift needs. We appreciate your patience and willingness to help! * Please print your name below, if you understand the statement above. Thank you for your interest in volunteering at the Animal Protection Center! Once your application is reviewed, one of our volunteer coordinators will reach out to set up an interview. We appreciate your patience and support!
