First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Work Phone
x

Cell Phone

Alt Email

Your Age:*

Can we call you at work?
Choose one: Yes No

What is the best way to reach you?

Are you over 18? (if under 18 we must have parents consent in writing.)*
Choose one: Yes No

I would like to volunteer and/or have a background in the following areas: (Check One)

Do you have any professional animal related experience (vet, technician, trainer, etc?)

Have you had any previous experience as a volunteer/employee with a humane organization/shelter/breed rescue group? If so, please list Group names,

How did you find out about R.C.H.S.?

If Other:

Briefly share your interest/reasons for wanting to volunteer with R.C.H.S.:

Do you have any General Comments/Questions regarding R.C.H.S.?

What weekdays are you available? M-F

What hours are you available on those days: ___ to ___ Please specify for each day you are available.

Are you able to work weekends? If so, please specify Saturday or Sunday:

What Times on the Weekend?

In case of Emergency please give us 2 people who we may contact: Name / Phone Number*

Randolph County Humane Society (R.C.H.S.) is not responsible for any damages initiated by the actions of any dog(s) or cat(s) or injuries that may occur while at RCHS. R.C.H.S. assumes no responsibility or liability for damages, including but not limited to personal liability or damages while at RCHS. We are a 501 c3 organization, and are not responsible for any or all injuries. The volunteer will not hold R.C.H.S. responsible of any Dog(s) or Cat(s) bite(s) any member of the volunteer or the family members. No verbal agreements between the Volunteer and R.C.H.S. shall be binding. You will be responsible to show proof of a Tetanus Shot, and it will remain on file. By submitting this application, you understand the above terms of the Randolph County Humane Society.*
Choose one: I agree