Please complete this application form if you are interested in becoming a Volunteer with our Montgomery County Animal Care and Adoption Center. Once you complete the form, click the continue button at the bottom. Your application will be reviewed by the Volunteer Coordinator within one week and then you will be contacted via email on how to proceed with scheduling yourself for orientation(s).

If you are under 18 years old, your parent/guardian must also submit an application. All minor's must be accompanied by a parent/guardian while volunteering. All minors and parent/guardians need to attend orientation(s) to volunteer. We offer orientations for the following:
- Cat Socialization: Minors may interact and handle cats under the supervision of their parent/guardian following an orientation.
- Dog Walking: Dog Walkers must be at least 18 years old. Minors may accompany the trained adult but the adult must be the sole dog handler. We cannot guarantee the safety of children while interacting with our dogs (we do not always know their history with children).

Other:

If you are seeking community service (court ordered/attorney recommended), please fill out the Court-Ordered Community Service Application by clicking here and email the application to millsdm@montgomerycountyva.gov
If you are seeking to fulfill 80 hours of service for the NRV Community College ACCE program, please pick up an application from our Center and/or contact Della Mills at 540-382-5795 x 57006 or millsdm@montgomerycountyva.gov

Personal Information

First name:

Last name:

Street 1:

Street 2:

Street 3:

City:

State:

* Zip: *

Cell phone:

Email address:

Date of birth:

(year optional)

***Under 18 Years Old:

If you are under 18 years old:

We require an application be submitted by your parent/gaurdian for minors to volunteer. Minors must be accompanied by a parent/guardian during any/all volunteer activities.

Please provide your parent/guardian information here:

First name:

Last name:

Street 1:

City:

State:

Zip:

Cell phone:

OK to call here

Email address:

Relationship:

Emergency Contact Information

First name:

Last name:

Cell phone:

Relationship:

Volunteer Activities

What kind of volunteer activities are you interested in?

Volunteering Availability

Please specify what times during the week you will most likely be volunteering.

Sun

Mon

Tue

Wed

Thu

Fri

Sat

From:

To:

Special Skills

If you have any special skills that may be helpful, please describe below.

Volunteer Agreement and Release

Volunteer Agreement

I agree to volunteer only in the tasks for which I have been trained by a staff member or a volunteer supervisor.

I agree and abide by the Code of Conduct and Rules and Regulations outlined in the Volunteer Handbook, accessible via the link on the Volunteer Portal Home Page.

I agree to submit to a background check should I choose to participate in any activities for which a background check is required.

Waiver

By checking the box below, I hereby note that I want to volunteer with the Montgomery County Animal Care and Adoption Center; that I have never been convicted of animal cruelty, neglect, or abandonment; that all of the information I have provided on the Volunteer Information Form and Volunteer Waiver is true; and that I agree to all of the following terms and conditions.

Terms and Conditions

My volunteer efforts on the behalf of the Animal Care and Adoption Center are provided strictly in a voluntary capacity and not as an employee of Montgomery County, VA, and are provided without any express or implied promise of salary, compensation, or other payment of any kind nor employee-type benefits.

I will familiarize myself and comply with ACAC and Montgomery County volunteer policies and procedures.
I will adhere to the highest standards of moral and ethical treatment of the animals in my capacity as a volunteer.
I understand that the ACAC and/or Montgomery County, VA, without notice or hearing, may terminate my services as a volunteer at any time or without reason.

Release

I understand that the handling of animals and other volunteer activities on behalf of the ACAC and the County may place me in a hazardous situation, result in injury or death to me or destruction of my personal property, or expose my own animals to transmissible viruses. On behalf of myself and my heirs, personal representatives, and assigns, I hereby release, discharge, indemnify, and hold harmless the ACAC and Montgomery County, VA, from 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 the ACAC and Montgomery County, VA.

Understanding that public relations are an important part of volunteer activities on behalf of the ACAC, I hereby authorize the ACAC to use any photographs of me in its possession for public relation purposes without prior notification required.

I Agree