Sheboygan Area Humane Society
Volunteer Application
Name:   Age: DOB:
           
Address:   City: ZIP
           
Phone:   Email:
           
Emergency Contact:   Phone:  
           
We schedule volunteers for 2 hour blocks (minimum). Are you able to commit to this time?
           
Availability: (mornings? specific days? etc)
           
Please check area(s) of interest:        
           
animal caretaking/dogs  
dog socializing maintenance/grounds
             
animal caretaking/cats  
cat socializing
office assistance
             
special events/fundraising assistance          
             
Please list any special talents you have, or specific areas you can help with:    
             
             
Have you volunteered in the past?     Adopted or fostered an animal from us?
             
Do you own any pets? If so what type?  
             
Are you currently a SCHS member?          
             
References: (not a family member and someone you have known for at leasty 2 years)    
             
Name:   Phone:    
             
Name:   Phone:    
             
Are you volunteering for a community service program? If so, how many hours?  
             

I understand that I will be working under the supervision of the shelter staff. It at any time I cause disruption or endanger the well-being of personnel or animals, I will be asked to leave immediately and requested not to return. I am responsible for my own transportation, clothing and personal items. I understand that discussion of SCHS clients, employees, volunteers and/or animal's former owners is a violation of privacy and a breach of confidentiality. I agree to abide by privacy/confidentiality policy during my tenure at the SCHS and after I am no longer affiliated with the agency. I understand that any violation of this may result in my immediate dismissal and/or legal action.

I release the Sheboygan County Humane Society, directors, staff, volunteers and supporters from any liability or claims of injury or illness arising from my participation in a volunteer capacity.

I acknowledge that I have thoroughly read and understand the terms and conditions of the above release. I waive legal rights to bring lawsuit agains the Sheboygan County Humane Society.

Volunteer Signature:_________________________________________________________Date:______________________
(Sign at Orientation)

This section for parent/guardian of volunteer under 18:

I understand that my child will be working under the supervision of the shelter staff. If at any time my child causes a disruption or endangers the well-being of personnel or animals, he/she will be ask to leave and requested not to return. I understand he/she may not be allowed to participate in all volunteer jobs. I am responsible for my child's transportation, clothing and personal items. I understand that discussion of SCHS clients, employees, volunteers and/or animal's former owners is a violation of privacy and a breach of confidentiality. My child agrees to abide by privacy/confidentiality policy during my tenure at the SCHS and after I am no longer affiliated with the agency. I understand that any violation of this may result in my child's immediate dismissal and/or legal action.

I release the Sheboygan County Humane Society, directors, staff, volunteers and supporters from any liability or claims of injury or illness arising from my child's participation in a volunteer capacity.

I acknowledge that I have thoroughly read and understand the terms and conditions of the above release. I waive legal rights to bring lawsuit agains the Sheboygan County Humane Society.

Parent/Guardian Signature:_______________________________________________________Date:______________________
(Sign at Orientation)