Volunteer Animal Rescue Application Form

1

First and Last Name:

2

D.O.B./Age

3

Street Address

4

City:

5

State:

6

Zip:

7

Home Phone:

8

Work Phone:

9

Cell phone:

10

Email Address:

11

Employer/Job Title:

12

May we contact for reference:

Yes

No

N/A

13

If yes, please provide name and phone # of employer:

14

Allergies or physical restrictions:

15

How did you hear about The Last Resort Rescue?

16

Why do you want to volunteer at The Last Resort Rescue?

17

Do you work with any other rescue organizations?

Yes

No

18

If so, please give contact information for that organization including name and phone #:

19

Please list any pets you currently own (or have owned in the past).

21

If you would like to comment more on your experience with the above, please do so here:

22

If you listed other, please explain:

24

If you would like to comment more on your experience with the above, please do so here:

25

If you listed other, please explain:

27

When are you available to volunteer? (check all that apply)

Weekdays

Weekends

28

Would you be willing to volunteer off the shelter premises?

Yes

No

29

Reference #1 (Name, phone # and relationship to self)

30

Reference #2 (Name, phone # and relationship to self)

31

Reference #3 (Name, phone # and relationship to self)

32

Any additional comments:

33

In case of emergency, who should we contact? (name and phone #)

34

By writing your name here, you are agreeing to the above liability waiver.

35

By writing your name here, you are stating that you are the parent/guardian of the above applicant and you grant your permission for them to volunteer with The Last Resort Rescue.

36

Anything else you would like to say, please note it here: