EmailMeForm
SMAS Volunteer Application and Waiver
Name
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First
MI
Last
Address
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Street Address
City
State / Province / Region
Postal / Zip Code
Email
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Age
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Phone
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I will volunteer in my own time, when convenient for me.
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Yes
No
Shelter Hours Available to Volunteer (Tue-Sat, 11am to 3:00pm).
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Employer
Occupation
Work Phone
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In case of emergency, please notify:
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Relationship
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Phone Number
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Address
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Street Address
City
State / Province / Region
Postal / Zip Code
Do you have a valid driver's license?
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Yes
No
Do you have any allergies or physical conditions, which might affect your volunteer work?
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Yes
No
If Yes, please explain.
Have you ever worked with animals?
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Yes
No
Why do you wish to volunteer at the Stephen Memorial Animal Shelter? Please describe any other volunteer experience you have had.
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Have you ever adopted an animal from us?
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Yes
No
If Yes, which one?
Have you ever surrendered an animal to us?
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Yes
No
If Yes, which one?
AREAS OF INTEREST I would like to help the Animal Shelter in the following ways:
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Dog Lover
Cat Cuddler
Special Event Helper
Special Shelter Projects
Other Ideas
I hereby acknowledge and understand that directly working with animals can subject a person to animal misbehavior such as biting, scratching, etc. If I am concerned about rabies, tetanus, or other diseases or maladies, I will pursue this matter with my personal physician. I understand that any vaccinations or treatments would be at own expense. I hereby waive any and all claims against and agree to hold harmless the Stephen Memorial Animal Shelter, its Board of Directors, officers, agents, and employees, for any and all liability associated with my being a volunteer.
I have read and understand all of the rules and guidelines in the Stephen Memorial Animal Shelter Volunteer manual and agree to abide by everything contained therein and any other rules that may be established by shelter staff. I understand that my volunteer activity with the animal shelter may be terminated at any time by shelter staff. I understand that as a Volunteer, I am not an employee of the Stephen Memorial Animal Shelter and am not entitled to any employment-related benefits.
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First
Last
Guardian's Signature (if candidate is under 18 years)
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First
Last