West Suburban Humane Society Volunteer Application Form

Before beginning this application, please take a few minutes to review our requirements for volunteers and our position descriptions for the volunteer areas. These items can be found on our website.

The volunteer application is the first step in the process for becoming a West Suburban Humane Society volunteer. Once you have completed the form, click the continue button at the bottom to submit. You will receive an email shortly after submitting your application asking for a response. Please watch for this email.

Name, address, and contact information

First name:

Last name:

Preferred Name:

Street 1:

Street 2:

City:

State:

* Zip: *

Home phone:

* OK to call me here

Cell phone:

OK to call me here

Email address:

Personal Health Insurance?:

Age

If you are under the age of 18, please indicate your age. Please note: volunteers under the age of 16 must volunteer with a parent, guardian, or relative over the age of 18. Please indicate the name of the adult who will accompany you for volunteering. This adult will also need to complete a separate application.

Age:

Name of Adult Volunteer::

Demographic Information

You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.

Date of birth:

(year optional)

Gender:

T-Shirt Size:

Employer:

Occupation:

Skills and Interests

Please indicate the areas in which you are interested. For more information about the volunteer areas, please see the position descriptions on our website. This information will be used to select a volunteer assignment that best meets your skills and interests. It will also be stored and you may be contacted to help with special events and projects.

Availability

Shifts are every week, Monday thru Friday, and every other weekend, Saturday and Sunday. Please indicate your availability:

Morning: 8:30 – 11:00 am (cleaning and socializing)

Afternoon: 12:00 pm - 3:00 pm (socializing)

Evening: 6:00 – 8:30 pm (light cleaning and socializing)

Emergency Contact

Whom should we call in the event of an emergency?

First name:

Last name:

Home phone:

* OK to call here

Work phone:

OK to call here

Cell phone:

OK to call here

Relationship:

Animal and/or Volunteer Experience

Please list any present or previous experience working with animals and/or volunteering:

Why did you choose West Suburban Humane Society?

Limitations

Volunteer work at the shelter often requires bending, lifting, reaching, and walking.

Please list any limitations that may interfere with volunteer work, including allergies:

How did you hear about the WSHS volunteer program?

Application Waiver

I acknowledge my understanding that the handling of animals and other volunteer activities may place me in a hazardous situation and could result in injury and I assume that risk. I understand that West Suburban Humane Society (WSHS) does not carry insurance for volunteers and I do have personal health coverage.

In consideration of my participation in the activities of the West Suburban Humane Society (WSHS), I do hereby agree to hold free from any and all liability the WSHS and its respective officers, employees and members and do hereby for myself, my family, members of my household, my heirs, executors, and administrators, waive, release and forever discharge any and all rights and claims for damages which may hereafter accrue to me arising out of or connected with my participation in any of the activities or duties of the WSHS.

I hereby do declare myself to be physically sound, having medical approval to participate in the activities of the West Suburban Humane Society.

I certify that the above information given is accurate and true.

I understand that before starting a volunteer position, I must first attend an orientation and training and sign a full volunteer waiver.

I Agree