First Name*
Last Name*
Address
City
State/Province
Zip/Postal Code -
Email*
Home Phone
Work Phone x
Cell Phone*
Alt Email
Year of Birth. *
Emergency Contact Name and Phone Number (include relationship)*
Tell us a little bit about yourself and why you are interested in volunteering *
Please list any specific training or skills that you have or degrees held (web design, graphic arts, languages spoken, non-profit training, vet tech, animal behaviorist/animal obedience training, human counseling, etc). *Please list any and all, even if you think that it is not pertinent to volunteer work with a non-profit or animal rescue. You might be surprised the ways in which seemingly unrelated training or experience can improve and expand upon our support to the community.
Which of the following volunteer opportunities are of interest to you? (Check all that apply.)
If you selected "other" in the preceding question, in what other ways are you interested in volunteering?
Are you fulfilling service hours as required by your school or organization?
If yes, what is the name of the school or organization requiring service hours? How many hours are required?
Please let us know who referred you or how you heard about us.
As a volunteer, I agree to the following:
1. To properly feed and handle animals under my supervision during volunteer activities.
2. Immediately notify a PAS foster parent or member if an animal under my supervision requires medical attention.
3. That all information accessed is confidential, and I agree to not reveal or disclose any information for any purpose to any other person or entity.
4. To never share my login information or allow database/website/email access to anyone, except for the PAS webmaster or approved board members.
5. To never use a publicly-shared computer or wi-fi connection when accessing PAS databases or information containing stored personal information about volunteers, adopters, applicants or other individuals.
Waivers and Release of Liability I understand that the behavior of domestic animals is sometimes unpredictable and that some domestic animals are capable of inflicting serious personal injury. I understand that working with animals may involve handling fecal materials. Knowing the risks of working with domestic animals, I agree to assume those risks and to release, indemnify and hold harmless Pet Adoption Services, Inc. and their agents, any venue, company, and/or property owner on which PAS-related events are held and their agents, forever from liability for any injuries or damages to any person, property, or otherwise, caused by my participation in said events and/or by any PAS foster animals, and from any causes of action, claims, suits, or demands whatsoever that may arise as a result of such injury or damages.
I agree that entering my name below will serve as my signature, and that by signing I agree, understand, and certify the following:
Signature*
Date*
