First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Cell Phone

Alt Email

Where did you find out about us (please be specific)?

Highest level of education achieved*

Place of employment of volunteer.*

How long have you worked at your current employer?*

Special knowledge, skills, abilities, hobbies*

What experiences have you had that may prepare you to work as a volunteer in the field of animal rescue?*

Why do you want to volunteer or what do you hope to gain from your volunteer experience?*

What kind of help would you like to offer to us? i.e. transporting, answering phone, helping with computer, etc...*

How much time, per week, or month, would you be able to devote to assisting us? *

Have you ever been convicted of a crime? If yes, please explain the nature of the crime and the date of the conviction and disposition. (Conviction of a crime is not an automatic disqualification for volunteer work.)*

Do you have a current valid driver's license?*
Choose one: Yes No

Do you have a reliable vehicle?*
Choose one: Yes No

Do you have a current and valid Auto Insurance policy?*
Choose one: Yes No

Tell us about your experience with animals*

Please list three people (only one family member) who know you well and can attest to your character, skills, and dependability. Please provide a phone number to contact them.*

How would you prefer to be contacted?*
Choose one: Email Phone Text

Please carefully read the following information before signing this application:

I understand that this is an application for, not a commitment or promise of, a volunteer opportunity.

I certify that I have and will provide information throughout the selection process, including on this application for a volunteer position and in interviews with Mitchell Animal Rescue that is true, correct, and complete to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and that I have not and will not withhold any information that would unfavorably affect my application for a volunteer position. I understand that information contained on my application will be verified by Mitchell Animal Rescue. I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant for a volunteer position with Mitchell Animal Rescue or my termination as a volunteer.

I also understand and agree to assume all risks involved in any duties I may perform as a volunteer. I agree to hold Mitchell Animal Rescue harmless from any injury(s) which I, my family members, and/or family pets may sustain during the course of my volunteer duties.

Signature of Volunteer*

Date:*