(*) indicates a required field
Name
First Name (*)
Middle Init. (*)
Last Name (*)
Street Address
City
State
Zip Code
Your Date of Birth (*)
Phone Numbers
Home:
Cell(*):
Work:
E-mail Address (*)
Preferred method of contact:
HomeCellWorkE-mail
----------For Applicants Under 18:----------
Parent/Guardian Name:
Contact Phone:
** Before volunteers under 18 can start, their parent/guardian must accompany them to CARE and sign a waiver **
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Have you had any previous experience (volunteer and/or employee) with any rescue group or animal shelter?
Please tell us why you would like to volunteer at CARE.
Are you fulfilling community service hours? (*)
YesNo
Are you fulfilling academic volunteer requirements? (*)
YesNo
List your pets
(Name, Age, Breed, Spayed/Neutered, Behavior Issues)
Days/Times Available (*)
Please list all days and AM/PM when you would be available
Medical Conditions/Physical Restrictions
Allergies
Date of Last Tetanus
Emergency Contact
Name (First/Middle/Last)
Street Address
City/State/Zip
Home Ph:
Cell Ph:
Work Ph:
INSURANCE WAIVER
The undersigned Volunteer and the Center for Avian Rehabilitation & Education, Inc. (CARE, Inc.) enter into the following binding Agreement:
Volunteer understands that CARE, Inc. makes no warranty as to age, health, breed, habits and/or any remote location could inflict upon any person or property, and for any illness of the animal or for the transmittal of any illness or parasite to any other pet or person. Volunteer further indemnifies and holds harmless CARE, Inc. for any actions, suits, fees and/or expenses (including actual attorney's fees) arising out of any injury from an animal on the premises of CARE, Inc. and/or any remote location.
The volunteer name on this application indicates they are at least 16 years old.
YesNo