HUMANE SOCIETY OF MONROE COUNTY
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| Date
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| Address
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| Home Phone Number
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| Cell Phone Number
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| Email
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| Date of Birth
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| Have you ever been convicted of a criminal offense?
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| If yes please explain
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Time Availability
Please indicate the days and times when you would be available:
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| When is the best time to reach you?
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Mornings 9am-12pm Afternoon 12pm- 5pm Evening 5pm-9pm
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| Are you volunteering to fullfill a court-ordered or school related community service?
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Yes No
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| If Yes, for what reason?
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| Number of hours required
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| Date Assigned
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| Date by which to be completed
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| Describe any training, experience, or formal education in animal care or welfare you have had that may help you in your volunteer assignment.
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| List skills and experience you have that can contribute to this organization
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| Place a check next to your areas of interest in SHELTER VOLUNTEER POSITIONS
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dog kennel assistant cat room attendant daily laundry daily cleaning shelter repair and maintenance assist with landscaping snow removal and lawn mowing foster parent can and bottle return vet tech skills dog and cat grooming
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| Place a check next to your areas of interest in COMMUNITY VOLUNTEER POSITIONS
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Adopt-a-thons educational events crafting and baking (fundraisers) fair booth dog walk auction Santa Paws pictures Mall Holiday Booth Thrift Store
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| Emergency Contact 1 (Name, Relationship, Phone)
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Emergency Contact 2
(Name, Relationship, Phone)
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| Reference 1 (Name, Relationship, Phone)
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| Reference 2 (Name, Relationship, Phone)
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