Petfinder

Name *REQUIRED*
Date of Birth *REQUIRED*
Address *REQUIRED*
City, State, ZIP *REQUIRED*
Home Phone *REQUIRED*
Work Phone
Cell Phone
Email Address *REQUIRED*
Best day(s) and time(s) to contact you
Emergency Contact Name *REQUIRED*
Emergency Contact Phone *REQUIRED*
EDUCATION
Are you presently enrolled as a student *REQUIRED*
Name of School
EMPLOYMENT HISTORY
Are you presently employed *REQUIRED*
Are you retired *REQUIRED*
Current Employer
Position
Phone
Length of Employment
VOLUNTEER EXPERIENCE AND TRAINING

(If you have volunteered at another organization)

Organization #1
When
How Long
Your Duties
Organization #2
When
How Long
Your Duties
BACKGROUND INFORMATION

(Please answer the questions below as completely as possible.)

Do you have any physcial disabilities that may affect or limit your work *REQUIRED*
If yes, please describe
Are you on any medication(s) and/or under medical supervision
If yes, please describe
Have you ever been convicted of a felony *REQUIRED*
If yes, please describe
GENERAL QUESTIONS
How did you hear about our volunteer opportunities *REQUIRED*
What interests you in volunteering with us *REQUIRED*
CERTIFICATION OF APPLICANT

By submitting this form, you certify that your answers on this application are true and complete to the best of your knowledge. You also grant your permission and consent for us to contact the necessary resources and references to verify your responses on this application.