Volunteer form – Arnprior Humane Society 2021

VOLUNTEER APPLICATION, QUESTIONAIRE AND WAIVER FORM

Thank you for your interest in our volunteer program! We appreciate your interest in assisting the shelter be the best it can be for our furry residents.

Please complete this questionnaire to help us understand where your interests lie, what you are able to do, and when you are available to volunteer with us.

VOLUNTEER INFORMATION

Your Name

Email Address

Address: Number & Street

City

Province:

Postal Code

Phone Number: Cell

Phone Number: Other

Your age range

Over 16 but under 19 19 to 29 30 to 50 Over 50

Emergency Contact Name:

Emergency Contact Address

Emergency Contact Relationship:

Emergency Contact Phone #

Questionaire

1. Why are you interested in volunteering for Arnprior & District Humane Society?

2. What activities are you interested in volunteering for? Please indicate all that apply:

Shelter duties - Cleaning, helping staff around shelter Shelter duties - Dog walker Note: You must be 19 years of age or older to be a dog walker. Bake sales - Donations Bake sales - Setup (assist with pricing & setup) Yard Sales - Morning set-up Yard sales - Afternoon clean up Walk-a-thons - Checkpoints, registration tables, etc. Gardening & yard work Other events such as pet shows/expos, pet store adopt-a-thons, micro-chip clinics, etc.

3. What areas would be preferable for volunteering? Please indicate all that apply:

Arnprior and surrounding area West Ottawa and surrounding area (Stittsville, Bells Corners, Kanata, etc).

4. When are you available to volunteer? Please indicate all that apply

Mondays

Mornings Afternoons Evenings

Tuesdays

Mornings Afternoons Evenings

Wednesdays

Mornings Afternoons Evenings

Thursdays

Mornings Afternoons Evenings

Fridays

Mornings Afternoons Evenings

Saturdays

Mornings Afternoons Evenings

5. When are you available to begin volunteering? Month/Day/Year

6. How often are you anticipating being able to volunteer? [example: 1/week, 2/month, weekends only etc.]

7. Are you volunteering because you require to a certain number of volunteer hours? If yes, please indicate the number of hours required and what the hours are for.

Yes No

Number of hours required.: _

Reason:

8. Please list any experience you have relating to caring for or working with animals.

9. Do you have any health concerns, for example, allergies, back injury, a limited ability to lift, which might affect your ability to work at the shelter or fundraising events? If yes, please list.

10. Do you have any pets at home?

Yes No

If yes, please list.

**NOTE: All pet owner volunteers with the Arnprior & District Humane Society [ADHS] should ensure that their own animal's vaccinations are up to date**

11. Are you a member of any other animal related organization? If "yes", Please list and describe your responsibilities with the organization.

12.Do we have your permission to contact them? If yes, please provide a contact name and phone number below.

Yes No Not applicable

If yes, please provide a contact name and telephone number

Upon being accepted as a volunteer, you will be required to complete and sign a VOLUNTEER CONSENT FORM & WAIVER.