Animal Shelter Volunteer Form

Department:

Volunteer Interests (check all that apply):

Cleaning

Walking

Laundry

Adoption Events

Dishes

Outside Maintenance

Name:

Address

Street:

City:

State:

Zip:

Telephone #:

Date of Birth:

Can you perform the volunteer duties without special accommodations for a disability or health concern?

Yes

(Answering No does not automatically disqualify you for volunteer status.)

Emergency Contact Information

Name:

Phone #:

Relationship to you: