Court Ordered Community Service Application

Please complete this application form if you are interested in fulfilling court-ordered community service (C.S.) hours at Heart of the Valley Animal Shelter. You must be at least 18 years old in order to fulfill Community Service hours at Heart of the Valley.

Our C.S. Volunteers do great work when it comes to supporting basic shelter operations and special projects!

FYI:

Community Service Volunteers complete their service in basic operational support by assisting with dishes, laundry, sweeping, mopping, deep cleaning etc.

Community Service Volunteers do not have direct contact with shelter animals.

Heart of the Valley will not accept volunteers who have been assigned community service due to the following charges: theft, violence, animal related charges, weapons charges, or sexual offenses involving minors.

Applicants must disclose reason for community service assignment at time of application.

All hours must be pre-scheduled by the Volunteer and Outreach Manager.

Contact information

First name:

Last name:

Street 1:

City:

State:

* Zip: *

Home phone:

OK to call me here

Cell phone:

Email address:

Date of birth:

Emergency Contact

In the event of an emergency whom should we notify?

1

2

First name:

Last name:

Street 1:

City:

State:

Zip:

Home phone:

Work phone:

Cell phone:

Relationship:

Have you ever been convicted of a felony?

A positive response will not necessarily bar you from volunteering, but failure to disclose will.

* Yes or No:

Yes

Please state

What is your offense?

Please state.

Skills

Our Community Service Volunteers do important work at Heart of the Valley! We're grateful you'd like to help!

If you have painting, carpentry, computer skills, etc. that you'd like to share, please let us know.

Who is overseeing your hours?

We need the contact information of the person/organization that oversees your service hours. This could be a Parole Officer, Community Corrections Officer, District Judge's Office etc.

First name:

Last name:

Title:

Street 1:

City:

State:

Work phone:

Availability

I'm interested in scheduling hours on these days/times...

I agree

By checking the 'I agree' check box, I hereby accept the following terms, conditions, and understanding:

VOLUNTEER AGREEMENT

By signing below, I indicate that I have read, understand and agree to the following:

1. I understand and agree that submitting this application form does not automatically register me as a Heart of the Valley, Inc. (“HOV”) volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering.

2. By submitting this form, I attest that the information I have provided on the form is true and accurate.

3. My services to HOV are provided strictly in a voluntary capacity as a Volunteer without any express or implied promise of salary or compensation of any kind. This would include any employment type benefits, including employment insurance programs, worker's compensation accrual in any form, vacations or sick time or any type of payment.

4. I will familiarize myself and comply with HOV policies and procedures applicable to Volunteers. I will abide by the mission, rules, regulations, policies and programs of HOV while I am a volunteer. In particular, I fully understand that HOV expects high standards of ethical treatment of animals under its care.

5. I fully understand that HOV is a "no kill" shelter and how HOV defines and implements this policy. I also understand that HOV may euthanize animals at any time for medical or behavioral reasons, including aggression or quality of life concerns, and agree to respect those decisions.

6. If my application to volunteer is accepted, I agree to be a volunteer for HOV.

7. I understand and agree that HOV’s website, internal files and records, including names and addresses of employees, volunteers, donors, applicants, membership lists and similar data are the sole property of HOV and that unauthorized disclosure of such information, its appropriation, changes, or alterations to it may constitute a criminal offense.

8. I understand that HOV is not responsible for any illness or injury caused by any animals that I come into contact with during my volunteer work. I hereby agree and release, indemnify and hold harmless HOV and associated Officers, Directors, Employees, and Agents from any and all claims, damages and liability arising from or related to my activities as an HOV volunteer.

9. I understand and agree that the behavior of animals is unpredictable and that some animals are capable of inflicting serious personal injury or death, as well as significant property damage. I acknowledge that while HOV will take every reasonable precaution to minimize the potential of danger posed by the animals under its care, it is never possible to guarantee the temperament and/or behavior of any animal at all times and under all circumstances. I therefore agree that if I choose to walk, handle, foster, or care for any HOV animal, I will do so at my own risk.

10. I understand that HOV, without notice or hearing, may terminate my services as a Volunteer at any time, with or without reason. I will promptly return all HOV supplies, equipment, records, moneys, and other items in good, clean condition. I also understand that I am not guaranteed a position in the Volunteer Program.

I REPRESENT THAT I AM OVER EIGHTEEN YEARS OF AGE AND ACKNOWLEDGE THAT I HAVE READ THIS AGREEMENT CAREFULLY AND I FULLY UNDERSTAND ITS CONTENTS AND IMPLICATIONS. I AM AWARE THAT THIS IS A WAIVER AND RELEASE OF LIABILITY AND INDEMNITY AGREEMENT, AND THAT IT IS BINDING AND ENFORCEABLE BY LAW.

I Agree