La Porte County Small Animal Shelter Volunteer Application
Today's Date
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Your first name
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Your last name
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Your date of birth
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Parent or Guardian's Name (If applicant is under 18 years old)
Your street address
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City
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State
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AK
AL
AR
AZ
CA
CO
CT
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip code
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Home or Cell Phone
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Additional Home or Cell Phone
E-mail Address
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Do you currently live with any pets?
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No
Yes
If so, please tell us a little about your pets. Pet #1 Name:
Pet #1 Species
Cat
Dog
Other
Pet #1 Info
Current Pet #2 Name:
Pet #2 Species
Cat
Dog
Other
Pet #2 Info
Pet #3 Name
Pet #3 Species
Cat
Dog
Other
Pet #3 Info
Pet #4 Name
Pet #4 Species
Cat
Dog
Other
Pet #4 Info
Are you a student?
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No
Yes
If you are a student, please list your current grade or college year.
Current employer:
Which days of the week are you most likely to volunteer?
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Mondays
Tuedays
Wednesdays
Thursdays
Fridays
A variety of days
What time of day are you most likely to volunteer?
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Morning
Afternoon
Do you prefer working with:
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Dogs
Cats
Both Dogs and Cats
Do you have any allergies?
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Yes
No
What kind of work would you like to do here?
Please choose all of the following that you are willing or able to do:
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walk/play with dogs
clean litter boxes
poop scoop kennels
play/pet/brush cats
bathe/groom animals
light office work
sweep/mop floors
Is there anything else you would like to tell us about yourself?
VOLUNTEER WAIVER OF LIABILITY ** I am aware that during volunteer service at the La Porte County Small Animal Shelter, I could be injured or bitten by an animal or have an allergic reaction to some of the solutions which are used to disinfect the animal areas. I hereby release the La Porte County Animal Shelter from any and all liability connected with my duties as a volunteer.
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Yes
No