Humane Society of Cowlitz County Adult Volunteer Application

Please complete this application form if you are interested in becoming a Humane Society of Cowlitz County volunteer. Once you complete the form, click the Continue button at the bottom.

REMINDER: This is the Adult Volunteer Application, if you are under 18 fill out the Youth Volunteer Application.

Name and Contact Information

First name:

Last name:

Middle name:

Street 1:

Street 2:

Street 3:

City:

State:

* Zip: *

Home phone:

OK to call me here

Cell phone:

OK to call me here

Email address:

Emergency Contacts

1

2

First name:

Last name:

Home phone:

OK to call here

Home phone:

OK to call here

Work phone:

OK to call here

Work phone:

OK to call here

Cell phone:

OK to call here

Cell phone:

OK to call here

Email address:

Relationship:

Background Information

Request for Criminal History Information: Child/Adult Abuse Information Act, RCW 43.43.830 through 43.43.845

Washington State law requires us to conduct background checks on volunteers who will or may have unsupervised access to vulnerable individuals. We may not accept volunteers who have been convicted of a crime under this law. Our volunteers work in a variety of different programs that may bring them into contact with these individuals; therefore, it is a requirement that every volunteer provide the necessary information to conduct the background check. Your application, any additional information you provide, and the results of the background check are kept confidential.

We will contact you with the results if there is a conviction result. If you do not hear from us, there is no result but you may check in with us at any time to inquire. The record information is furnished solely on the basis of name and/or description similarity with the applicant of inquiry. If necessary, we may ask for a fingerprint for positive identification or non-identification.

Aliases/Maiden Name(s):

Date of birth:

Age:

Gender:

Do you agree to a background check?:

Have you ever been convicted of a crime:

If yes, was it a felony or misdemeanor? What was the nature of the charge(s)? Please provide dates.

Medical Information

Please list the following. Any information listed will remain confidential.

1. Any medical/physical conditions that we should be aware of.

2. Any allergies we should be aware of.

3. If you have a doctor or hospital you prefer in the case of an emergency.

Why are you interested in volunteering with HSCC

Why do you want to volunteer for the Humane Society of Cowlitz County? Please detail what you think would make you a good fit for our organization.

Area of Interest

Please indicate the areas you are interested in helping with.

* Assignment Preference:

1st choice:

2nd choice:

Comments:

Skills

What other skills do you have that would be useful in our volunteer program? Please check the boxes below, and detail your experience in the comment box. (This will not change the position(s) you have chosen.)

Availability

Please indicate the day(s) and time(s) you are usually available to volunteer.

Warning: Afternoon/Evening times(2 pm to 6 pm) are very popular and there are not many opening.

Early mornings to noon is when the most help is needed and when we usually have opening.

Shelter Volunteering Hours for adult Volunteers:

Mon - Fri, 9 am - 6 pm

Saturday, 9 am - 3:30 pm

Sun

Mon

Tue

Wed

Thu

Fri

Sat

From:

To:

Comments:

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
Event Sign-ups, Updates, Announcements, and more!

Schedule reminders

Volunteer Agreement

By checking the box below, I certify that all statements in this volunteer application are true and have been given voluntarily.

I understand that my participation in any of the above-named volunteer positions is strictly on a volunteer basis and that volunteers are not classified as employees, agents or servants of the Humane Society of Cowlitz County and thus any injuries I might sustain during the course of my volunteer activities are not entitled to coverage under the Humane Society of Cowlitz County’s worker’s compensation policy. I agree to release and hold harmless the Humane Society of Cowlitz County from and against any and all loss, damage, claims, liability, costs and expenses of any nature whatsoever, including without limitation, attorney’s fees and disbursements, arising from or occasioned by my participation in the Humane Society of Cowlitz County’s volunteer program.

I understand there are certain risks inherent in handling animals and I accept these risks.

I commit to providing at least eight hours of service per month, for a minimum of three or six months. I understand that my volunteer service is an integral part of the daily operations of the shelter and I agree to notify the Volunteer Office immediately of any schedule changes or if I wish to discontinue my volunteer services.

I agree to hold absolutely confidential all information that I may obtain concerning patrons or animals. I understand that an intentional or unintentional violation of confidentiality may result in disciplinary action, including termination of volunteer services and/or possible legal action by others (i.e. patrons).

I fully understand that the Humane Society of Cowlitz County expects high standards of moral and ethical treatment of animals under its care. I agree to adhere strictly to these standards in my voluntary capacity and exercise compassion, care, and positive training methods with all animals.

I agree to treat patrons, staff, volunteers and other guests of the Humane Society of Cowlitz County with courtesy, sensitivity, and professionalism. I will seek management help for any questions or situations beyond my knowledge or training.

I agree to advise my supervisor of relevant information regarding an animal or patron in a timely manner. I will communicate job-related problems, concerns, differences of opinion, conflicts, or suggestions to an animal care supervisor or the Volunteer Programs Coordinator.

I agree to limit my activity to my assigned work area unless otherwise directed by the Volunteer Coordinator or staff member.

I agree to adhere to my schedule and to sign-in and out procedures. I will notify my department supervisor or Volunteer Coordinator when unavailable for my shift.

I agree to maintain appropriate volunteer attire and a well-groomed appearance for all assignments.

I understand that the Humane Society of Cowlitz County reserves the right to terminate my volunteer status at any time, for any circumstances which, in the judgment of the Volunteer Coordinator, Director of Shelter Operations, Director of Human Resources or President, would make my continued service as a volunteer contrary to the best interest of the agency. I have read and understand each of the above conditions.

I agree that upon receiving electronic access to the HSCC volunteer manual I will read the applicable manual in its entirety, and I agree to abide by the policies and procedures outlined within.

I Agree

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