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:

Age:

Last year Grade/High school completed:

Last Year College/Grad school completed:

Are you currently enrolled in school?:

If YES, name of school.:

Contact Information

First name:

Last name:

Street 1:

City:

State:

* 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.

Hobbies, Interests, Clubs And Organizations

Please tell us about your other interests..

Clubs And Organizations:

Hobbies And Interests:

Pets

Tell us about your pets.

Availability

Please indicate the days and times you are usually available to volunteer.

Sun

Mon

Tue

Wed

Thu

Fri

Sat

From:

To:

My availability is:

From:

to:

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.

Emergency Contact

In the event of an emergency whom should we notify?

First Name:

Last Name:

City:

State:

Home phone:

OK to call here

Work phone:

OK to call here

Cell phone:

OK to call here

Relationship:

Employer

Please list your current or most recent employer, if applicable.

What is your occupation?:

Employer name:

City:

State:

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

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