Volunteer Application | Senior Dog Haven & Hospice

Today's Date

Full Name

Are you over 18?

Yes

No

(Please be aware that we only accept volunteers 18 and over)

Driver’s License #:

Address

City

State

Zip

Phone (day)

Phone (evening)

Cell

Email

Employed By, or School Attending

Birthday (mm/dd/yy)

How did you learn about our volunteer program? How did you learn about our volunteer program?

Medical Release

I have the following allergies (food, animal, medical, etc.)

I have the following medical conditions (diabetes, heart condition, seizures, etc.)

In case of emergency, I authorize Senior Dog Haven & Hospice, Inc. to arrange for emergency medical treatment (911) after attempting to notify the contacts listed below. List 2 personal or professional contacts below.

Yes, I agree

List 2 emergency contacts below.

Emergency Contact 1 Name

Emergency Contact 1 Phone Number

Emergency Contact 1 Relationship To You

Emergency Contact 2 Name

Emergency Contact 2 Phone Number

Emergency Contact 2 Relationship To You

Advisory:

You are strongly urged to have a current tetanus vaccination to protect yourself in case you are cut, scratched or otherwise injured in such a way that a tetanus infection could harm your health.

I Understand

Why would you like to be an SDHH volunteer?

Are you involved in any other animal welfare organization?

Yes

No

If yes, what is / was your involvement?

List other volunteer activities below.

Which organization(s)? Past or Present

Activities you performed:

Detail any experience you have had with animals, including your own pets.

Please list two (2) personal or professional references not directly related to you.

Reference 1 Name

Reference 1 Phone Number

Reference 1 Relationship To You

How do you know this person? (co-worker, friend, neighbor, etc.)

Reference 1 Address

Reference 1 City, State, Zip Code

Reference 2 Name

Reference 2 Phone Number

Reference 2 Relationship To You

How do you know this person? (co-worker, friend, neighbor, etc.)

Reference 2 Address

Reference 2 City, State, Zip Code

Volunteer Interests
In which two areas are you most interested in volunteering (Please number in order of preference, with #1 being the most preferred):

Information Booths / Adoption Events Preference #:

Fostering Preference #:

Fundraising / Special Events Preference #:

Public Relations and Publicity / Digital Photography Preference #:

Writing Preference Preference #:

Adoption Facilitation Preference #:

Transporting Preference #:

Events Coordination Preference #:

Other special skills or interests you would like to share:

Availability

When can you begin volunteering?

How many hours per week?

Select the days/times you are available to volunteer with SDHH, Inc.

Volunteer Agreement and Release

I am requesting a volunteer position within Senior Dog Haven & Hospice, Inc. I agree to read and follow the rules and guidelines of the organization. I agree to not hold any director, employee, board member, or any individual personally or otherwise responsible in the event that I sustain personal, financial, emotional, or property loss/damage while serving the organization. I agree to follow the supervision of all persons involved in volunteer management. I understand that as a volunteer I am an important representative of Senior Dog Haven & Hospice, Inc. and must do my best to represent SDHH in a manner that is consistent with its articles, by-laws, guidelines, and philosophies. I have read and understand the volunteer release and agree to adhere to its entirety.

Yes, I agree.

Type Full Name to Acknowledge Rules and Guidelines