You must be 18 years old and commit a minimum of twenty hours of service in order to complete your community service hours with the Humane Society of Washington County.


If you have been or are going to be convicted of a felony or any offense involving theft, you CANNOT fulfill your community service hours with our organization.


Name and address

Personal Information



Court Contact

Please provide name, phone number and email address of court appointed contact person.



Conviction

Please discuss below what your conviction is and any additional information you wish to provide.



Volunteering

Please discuss below why you want to fulfill your community service at the HSWC



Hours Required


Date to Start


Availability

Please indicate below your available work schedule shifts available Monday - Friday, 10:00 am - 4:00 p.m.



Emergency Contact Information


Waiver and Release

I understand that the handling of animals and other volunteer activities on behalf of The Humane Society of Washington County, TN may place me in a hazardous situation and could result in injury to me or my personal property. I release Humane Society of Washington County, TN and all of its employees, agents, and board members, from liability of any nature, whether or not the basis of such liability is presently known to either party. It is understood by the parties to this agreement that I/we will not bring suit or any claims against Humane Society of Washington County, TN, its employees, agents, board members, or pet owners. This agreement shall be binding on all parties, their heirs, and assigns.


Understanding public relations is an important part of a Volunteers activities on behalf of Humane Society of Washington County, TN. I hereby authorize Humane Society of Washington County, TN to use any photographs of me in its possession for public relations purposes. I ask that Humane Society of Washington County, TN use reasonable efforts to give me advance notice of any such use, but such notification is not a condition to release photographs for public relations purposes.


In consideration of this opportunity to volunteer, I agree to the following terms and conditions, intending to be legally bound by them


All information concerning animals, clients, staff, financial data, business records and employees is confidential. No information about donors, patrons, or other volunteers may be released without specific authorization. The board of directors, staff and our patrons rely on our volunteers to conform to this rule of confidentiality. Failure to maintain confidentiality may result in termination of the volunteers relationship with HSWC. Violations of this policy may also result in personal liability.


An HSWC volunteer, acting in an official capacity shall not take any action that would result in the volunteers financial benefit or the benefit of his immediate family members. Volunteers will not ask for or receive for themselves or for a member of their household, directly or indirectly, any monies or gifts from the community. Any potential conflict of interest should be disclosed. It will not preclude volunteer service if it is declared appropriately.


Volunteers are likewise subject to immediate dismissal if they engage in any activity which might be construed as sexual harassment, or use of HSWCs name, equipment or materials for any illegal or unethical purposes. Any volunteer who observes another volunteer or staff member engaged in unethical or illegal activity should immediately report the activity to the Volunteer Coordinator. The confidentiality of the reporting volunteer will be protected.


All media inquiries are to be referred to the Public Relations Director. These include inquiries pertaining to public complaints/incidents, as well as routine matters such as requests for interviews, response to press release information, or special events. If the Public Relations Director is not available, please refer the media to another staff member.


I agree to comply with all of the rules and I understand that failure to do so may result in my immediate termination as a volunteer.