Please complete this application form if you are interested in becoming a Washington County Johnson City Animal Shelter volunteer. Once you complete the form, click the Continue button at the bottom.

Name and address

Please enter your name, address and phone number below. Your Volunteer Number will be the last 7 digits of the phone number entered in the cell phone column. If you only have a home phone number, please enter this instead. If nothing is entered, please see reception to receive your volunteer number. This number is used to sign into the system which helps us keep track of volunteers as well as allow you to view assignments and print service record logs for community service!

First name:

Last name:

Street 1:

Street 2:

City:

State:

Zip:

Cell phone:

OK to call me here

Email address:

Emergency Contact

Please list the contact info for your emergency contact below

First name:

Last name:

Home phone:

OK to call here

Cell phone:

OK to call here

Relationship:

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:

Gender:

School:

VicNet Login

Below will be the password that you will use to log into the remote volunteer login to view volunteer assignments from the web as well as to sign up for new assignments

Please enter a password that:

Is between 8 and 30 characters long

Password:

Confirm password:

Availability

Please indicate the days and times you are usually available to volunteer. If you are only sometimes available, please check the box just in case!

Email Preferences

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.

What kinds of email would you like to receive?

Electronic newsletters

Recruitment appeals

Schedule reminders

Experience

Please enter any relevant experience you may have in working with and handling animals

Experience:

I am comfortable handling larger dogs

I have pets at home

I have worked at a shelter before

Motivation

What made you interested in volunteering at our wonderful shelter?

Motivation:

Interest in taking dogs for hikes

Interested in leadership opportunities

Raising awareness at your college

Skills

Please list any skills below that you have that may help our mission to help animals

Restrictions/Constraints

Please list any restrictions/constraints that would affect your ability to consistently volunteer

Restrictions:

Allergic to cats

Allergic to dogs

Waiver

Please enter your name, Perent or Legal Guardian's name (if under 18), and the date in this box after you have read and checked the Waiver & Release below.

Electronic Signature:

Application Date:

Waiver and Release

In consideration for the opportunity to volunteer with the Washington County/Johnson City Animal Shelter, I hereby represent and agree to the following:

1. I, the Volunteer, am 18 years of age or older, or I am the parent or legal guardian of the volunteer who is less than 18 years of age

2. I understand, recognize, and appreciate that there are risks and dangers, inherent or otherwise, in volunteering for the WC/JC Animal Shelter, including but not limited to those risks associated with the handling of animals and the performance of other similar volunteer activities. I am submitting this Release and Liability Waiver Voluntarily and of my own free will. If the Volunteer is younger than 18 years of age, I hereby consent to the Volunteer's full participation and the volunteering of his/her services to the Washington County/Johnson City Animal Shelter

3. I, on behalf of myself and my heirs, executors, administrators, assigns, and any and all persons claiming by and through me, on behalf of the Volunteer if the Volunteer is younger than 18 years of age, hereby release and agree to hold harmless and indemnify the Washington County/Johnson City Animal Shelter and all of its officers, directors, employees, agents, board members, former employees and representatives from any and all claims, liabilities, and damages, known or unknown, that I and or the Volunteer (if the Volunteer is younger than 18 years of age) may sustain from any bodily injury, personal injury, or property damage that may arise from and/or the Volunteer's volunteering for the Washington County/Johnson City Animal Shelter. This Release and Liability Waiver shall be binding on all parties, their heirs, successors, and assigns.

4. I understand that public relations are an important part of a Volunteer's activities on behalf of the Washington County/Johnson City Animal Shelter. I hereby irrevocably grant the Washington County/Johnson City Animal Shelter and its agents the right to use my and/or the Volunteer's, if the Volunteer is younger than 18 years of age, name, likeness, and any photographs of me for any purpose, including public relations, promotion, advertising, nor other purposes. To the extent practicable, the Washington County/Johnson City animal Shelter will make reasonable efforts to give me advance notice of any such use, but such notification is not a condition to the use of my and/or the Volunteer's name, likeness, or any photographs of me.

5. I agree to comply with All of the Washington County/Johnson City Animal Shelter's rules, policies, and procedures, and I understand that my failure to do so may result in my no longer being allowed to volunteer for the Washington County/Johnson City Animal Shelter

6. I acknowledge that I have read and understand the entire Release and Liability Waiver. By signing below, I hereby accept the above terms and conditions and agree to be legally bound by them.

I Agree