Springfield Humane Society, Inc.

Since 1941

 

Volunteer Information

 

Please PRINT clearly

 

Name________________________________________  Date______________________

 

Address_____________________________________City_________________________

 

Physical address if different from above_______________________________________

 

Phone: Home_________________  Work___________________  Cell_______________

 

e-mail_________________________________ Date of birth_______________________

 

**Emergency contact name & number______________________________________

 

_______________________________________________________________________

 

 

Are you currently enrolled in school?  Yes  No If yes, what school?__________________

 

Previous volunteer experience ________________________________________________________________________

 

________________________________________________________________________

 

Do you have any experience working with animals? Describe________________________________________________________________

 

_______________________________________________________________________

 

Do you have pets?  Yes  No  Are they spayed or neutered?  Yes  No

 

Are you currently employed? Yes  No  If yes, may we contact you at work?  Yes  No

 

Employer_____________________________  Brief description of what you do at work

________________________________________________________________________

List any special skills, training, hobbies ________________________________________________________________________

 

________________________________________________________________________

 

 

Please check the volunteer opportunities in which you would be interested:

 

___ cat grooming/socializing    ___ photography              ___ gardening/yard work  

___ dog walking                        ___ computer wizard        ___ marketing/PR     

___ special events                      ___ foster parent              ___ fund raising

___ general cleaning                  ___other ideas ________________________

 

Please indicate days and times you are available:

 

Wed:________   Thurs:________   Fri:________ Sat:________

 

 

Please list two references that are not family members:

 

________________________________________________________________________

Name                                                 Relationship                                      Phone

 

________________________________________________________________________

Name                                                 Relationship                                      Phone

 

My signature gives permission to the Springfield Humane Society to verify all information given herein.

 

Signed________________________________________________Date______________

 

 

 

 

 

 

 

 

 

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Student Volunteer Overview