P.A.W.S. Volunteer Application Form
YOU MUST BE "18" TO SUBMIT A VOLUNTEER APPLICATION.
YOUR APPLICATION MAY BE DELETED IF YOU DON'T VOLUNTEER WITHIN 3 MONTHS OF SUBMITTING YOUR APPLICATION.
Read the P.A.W.S. Volunteer Handbook for more information.
Demographic Information
Please 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:
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
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1984
1983
1982
1981
1980
1979
1978
1977
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1973
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1969
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1967
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1965
1964
1963
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1961
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1958
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1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
*
Age:
Last year Grade/High school completed:
Choose
0
0:00
1
10
11
12
2
3
4
5
6
7
8
9
*
Last Year College/Grad school completed:
Choose
0
1
2
3
4
5
6
7
*
Are you currently enrolled in school?:
Choose
NO
YES
*
If YES, name of school.:
Contact Information
First name:
*
Last name:
*
Street 1:
*
City:
*
State:
Choose
IN
KY
OH
*
Zip:
*
Home phone:
OK to call me here
Work phone:
OK to call me here
Cell phone:
OK to call me here
Email address:
*
Skills And Experience
Please tell us if you have experience working with animals and explain your experience. In the skills/training fields please check all of the areas you feel you have moderate to excellent skill.
Have experience working with animals?:
Choose
NO
YES
*
If YES, please explain::
Skills / Training:
Animal Enrichment
Computer Data Entry
Computer Office Programs
Dog / Cat Grooming
Dog Training
Electrician
Groundskeeper
Humane Education
IT Experience
Landscaper
Maintenance
Office / Office Equipment
Plumber
Receptionist
Secretarial
Shelter Cattery Aide Experience
Shelter Kennel Aide Experience
Vet Tech
Hobbies, Interests, Clubs And Organizations
Please tell us about your other interests..
Clubs And Organizations:
*
Hobbies And Interests:
*
Pets
Tell us about your pets.
Do you currently own dogs or cats?:
Choose
NO
YES
*
If YES, are they spayed and neutered?:
Choose
NO
YES
If NO, why?:
What pets have you owned?:
Birds
Cats
Dogs
Exotic
Fish/Aquariums
Hamsters/Guiney Pigs
Horses
Mice/Rats
Rabbits
Reptiles
Sheep/Goats
Availability
Please indicate the days and times you are usually available to volunteer.
Sun
Mon
Tue
Wed
Thu
Fri
Sat
From:
7:00am
7:30am
8:00am
8:30am
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
8:30pm
9:00pm
9:30pm
10:00pm
7:00am
7:30am
8:00am
8:30am
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
8:30pm
9:00pm
9:30pm
10:00pm
7:00am
7:30am
8:00am
8:30am
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
8:30pm
9:00pm
9:30pm
10:00pm
7:00am
7:30am
8:00am
8:30am
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
8:30pm
9:00pm
9:30pm
10:00pm
7:00am
7:30am
8:00am
8:30am
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
8:30pm
9:00pm
9:30pm
10:00pm
7:00am
7:30am
8:00am
8:30am
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
8:30pm
9:00pm
9:30pm
10:00pm
7:00am
7:30am
8:00am
8:30am
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
8:30pm
9:00pm
9:30pm
10:00pm
To:
7:00am
7:30am
8:00am
8:30am
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
8:30pm
9:00pm
9:30pm
10:00pm
7:00am
7:30am
8:00am
8:30am
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
8:30pm
9:00pm
9:30pm
10:00pm
7:00am
7:30am
8:00am
8:30am
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
8:30pm
9:00pm
9:30pm
10:00pm
7:00am
7:30am
8:00am
8:30am
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
8:30pm
9:00pm
9:30pm
10:00pm
7:00am
7:30am
8:00am
8:30am
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
8:30pm
9:00pm
9:30pm
10:00pm
7:00am
7:30am
8:00am
8:30am
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
8:30pm
9:00pm
9:30pm
10:00pm
7:00am
7:30am
8:00am
8:30am
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
6:00pm
6:30pm
7:00pm
7:30pm
8:00pm
8:30pm
9:00pm
9:30pm
10:00pm
My availability is:
Choose
Not available until this date
Ongoing
Ongoing, except between these dates
Only between these dates
From:
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
to:
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
Assignment Preference
The following volunteer assignments may currently be available. Please check the volunteer assignments you are interested in. NOTE: YOU MUST CHECK AT LEAST ONE ASSIGNMENT.
*
Assignment Preference:
09 Volgistics Operator / Data Entry
12 Colerain PetSmart Cat Care
15 Transports
16 Youth Parent / Guardian
17 Youth Community Events
18 Youth P.A.W.S. Fundraisers
19 Youth Humane Ed
Cat Socialization
Clean kennels
Cleaning/Maintenance
Dog Walking/Socialization
Gardening - yard work
Off Site Events
OTHER
Reception / Front Desk
Rummage Sale Sort
Spring Rummage Sale 2019
Emergency Contact
In the event of an emergency whom should we notify?
First Name:
*
Last Name:
*
City:
State:
Choose
IN
KY
OH
Home phone:
OK to call here
Work phone:
OK to call here
Cell phone:
OK to call here
Relationship:
Choose
Aunt
Boyfriend
Brother
Case Manager
Cousin
Daughter
Daughter-In-Law
Domestic Partner
Father
Fiance
Friend
Girlfriend
Grandfather
Grandmother
Guardian
Husband
Mother
Nephew
Niece
Sister
Son
Son-In-Law
Uncle
Wife
*
Employer
Please list your current or most recent employer, if applicable.
What is your occupation?:
*
Employer name:
*
City:
State:
Choose
IN
KY
OH
Volunteer Release / Waiver Signature
Volunteer Signature:
*
RELEASE / WAIVER
I understand that the handling of animals and other Volunteer activities on behalf of P.A.W.S. of Dearborn County & Humane Center may place me in a hazardous situation and could result in injury to me or my personal property. On behalf of myself, and my heirs, personal representatives and assigns, I hereby release, discharge, indemnify and hold harmless P.A.W.S. of Dearborn County & Humane Center and its respective directors, officers, employees and agents from any and all claims, causes of action and demands of any nature, whether known or unknown, arising out of or in connection with my Volunteer activities on behalf of P.A.W.S. of Dearborn County & Humane Center. Further, I understand that public relations are an important part of a Volunteer’s activities on behalf of P.A.W.S. of Dearborn County & Humane Center. I hereby authorize P.A.W.S. of Dearborn County & Humane Center to use any photographs of me (includes electronic/digital audio and video recordings) in its possession for public relations purposes. I ask that P.A.W.S. of Dearborn County & Humane Center use reasonable efforts to give me advance notice of any such use, but such notification is not a condition, either precedent or subsequent, to release photographs for public relations purposes.
I Agree