* indicates a required field

Last Name *

First Name *

Birth Date *

Age *

Address, City, State, Zip *

Your Email *

Best Phone Number to Reach You *

Occupation *

Emergency Contact & Relationship *

Emergency Contact Phone *

Why are you interested in becoming a volunteer?

Are you completing these hours for Military School? *

If yes, how many hours are needed?

Describe any previous experience working with animals *

List present and previous volunteer jobs *

List additional information that may be useful (hobbies, interests, special skills, training, etc.) *

I would like to volunteer on average ____ hours per month *

Are you willing to come in at least 1 time a month to volunteer? Yes or No *
-YesNo

Please indicate which days you would most prefer to volunteer (this may also be on a flexible schedule): (You may select more than one)
MondaysTuesdaysWednesdaysThursdaysFridaysSaturdaysSundays

Have you ever been convicted of Animal Cruelty, Theft, Sexual Offense, or Drug/Alochol Abuse (Please indicate Yes or No) *
---YesNo

If Yes, please add any additional information:

Select all areas of volunteer interest *
PetSmart Cat Adoption CenterFoster CareTransporterSpecial EventsAdministrative ProjectsCat SocializationDog Socialization/Dog WalkClean Up Crew (laundry, dishes, cleaning cat cages, etc.)Shelter MaintenanceShelter LandscapingSmall Critter Socialization

Have you had any COVID-19 symptoms, reparatory symptoms or complained of a sore throat or cough in the past 24 hours? *
---YESNO

Have you experienced a fever in the past 24 hours? *

Have you or a close family member been in contact with anyone who has received a positive Coronavirus test or is awaiting test results in the last 14 days? *
---YESNO

Wearing a face mask is required at all times while at our facility. Are you able to bring your own mask and wear it at all times? *
YESNO

I have read and understand the volunteer rules and guidelines.
I understand that if I do not abide by all of these rules, my service as a volunteer can be terminated or suspended. I also
understand that these rules and guidelines are set forth to protect the animals, the staff and myself. I agree to conduct myself
in a courteous and professional manner as a volunteer and as a representative of the Heritage Humane Society.
I agree to abide by all Heritage Humane Society’s policies and procedures.

I Agree *
-YesNo

Today's Date *