Valley Humane Society Volunteer Application

Thank you for your interest in volunteering with Valley Humane Society. Volunteers play a vital role within our organization, and the animals depend upon the love and care provided by our volunteers.

Please complete the application below (you must be 16 years of age or older to participate in the regular volunteer program).

Personal Information: (for VHS use only)

(Click on the grey box to enter your information)

First and Last Names:

Date of Birth if under 18:

Mailing Address:

City, State, Zip:

Phone #:

Email address:

Emergency Contact:

Relation:

List any special skills, training, interests or hobbies:

Are you volunteering to fulfill a court-ordered community service requirement? Yes or No (If yes, special conditions apply.)

Have you ever been convicted of any offense relating to or involving cruelty to or neglect of an animal? Yes or No

Do you have experience working with/handling animals? Yes or No

If yes, please describe:

Are you allergic to latex (or items containing latex)? Yes or No

Do you have any allergies to dogs, cats, cleaning agents, etc? Yes or No

If yes, please indicate agent(s) to which you are allergic:

Are you a seasonal/winter visitor? Yes or No

If yes, please indicate the months during which you are in AZ and available for volunteering:

Are you bilingual? Yes or No

If yes, language(s) spoken/read:

In which of the following ways are you interested in helping:

Bathing/Grooming Yes or No

Office/Clerical/Data Entry Yes or No

Dog Walking/Socializing Yes or No

Cat Cuddling/Socializing Yes or No

Adoption Events assistant Yes or No

Community Outreach Assistant Yes or No

Kennel assistant Yes or No

Thrift Store Assistant Yes or No

I give my permission to VHS to verify the information given:

Volunteer applicant signature:

(Parent or guardian signature if volunteer applicant is under 18 years of age)

Date

Deb

2019-02-13

Pinal County