Hanover Humane Society Volunteer Addendum Application

VOLUNTEER APPLICATION Please do NOT mail or fax this form to Hanover County! Please mail to: Hanover Humane Society, P. O. Box 1011, Ashland, VA 23005 Attn: Volunteer Coordinator

Name ______

Address ______

______

Phone (day) ______Phone (evening) ______

Email ______

I. Skills and Interest

1. Education and background:

______

2. Current occupation:

______

3. Hobbies, skills, interests:

______

4. Previous volunteer experience:

______

II. Community Service

Are you fulfilling community service hours by volunteering with us? ____Yes ____No

If yes, please circle one of the following: SCHOOL COURT ORDERED

If court ordered, please indicate the reason: ______

*** Reference (other than parent or acquaintance): Name/relationship/phone #:______PLEASE NOTE: Community Service Hours must be approved by the Volunteer coordinator. Applications for CSH without a reference will be rejected. All service volunteers are responsible for tracking their service hours. III. Areas of Interest

To help us match you with tasks, programs or assignments you enjoy, please indicate the types of volunteer activities that interest you.

 Safehouses - especially ones that can take in "needy" animals - not a kennel situation.

 Dog handlers at the adoption stand. Must be 16 years old. Must be able to handle large dogs on a leash. Requires training.

 Petsmart Adoption Center: Many of our adoptable cats are housed at two Petsmart locations. Help is needed each a.m. and p.m. to do feeding and cleaning. Must be 16 years old. Exposure to cat hair and dander, feces. Training required.

 Adoption Stand Coordinator(s) - Someone who can be sure we have current information (newsletters, brochures, business cards, spay/neuter info) available.

 Transporters – this could include transportation for donations to our facility or transport a dog to our adoption stands at the two Petsmart locations. This requires use of your vehicle.

 Volunteer Coordinator: Someone to conduct new volunteer orientation, contact volunteers for special activities or needs, track volunteer hours.

 Fund raising Committees: Serve on the committee which pulls special events together. Help is needed for recruiting sponsors, doing advertising, selling tickets, planning decorations, party favors, planning menus, etc. Committee meets as needed.

 SNIP volunteer: This is our spay / neuter program (Spay / Neuter Is Progress). This could involve returning phone calls, filling out paperwork, assisting with the transports, education on importance of spaying / neutering, etc. These transports occur on every other Friday and would require you be on-site from 6:30 a.m. to 9:30 a.m. for dropoffs, and/or 3:00 – 6:00 p.m. for pickups.

 AniMeals: This is a new program we would like to get off the ground. This will involve offering meals for animals in homes where the people are either not mobile (such as Meals on Wheels) or low-income. Serving on this committee will involve contacting community resources to determine need and coordinating how our organization can serve those needs. We need a program chairperson for this as well as volunteers.

 Dog walker at our facility: Taking the dogs in our facility for walks. Must be 18 years old. Must demonstrate ability to handle large dogs. High noise area; exposure to chemicals, dog hair and dander, and feces.

 Landscapers: Love to work in the garden? Our property has many beautiful flower beds needing your TLC. We also need help developing our walking trail, identifying the plants and trees along it, and maintaining it once we get it all done.

 Grant writers. No experience necessary, but would be nice! This involves access to a computer and the internet.

 Administrative Work: Requires training; file volunteer forms, file adoption contracts, process donations, Send thank you letters to donors.

 Wellness Clinic: We provide Wellness Clinics for the public and their dogs and/or cats. The Wellness Clinic will occur on the first and third Wednesday of each month from 4:00 – 7:00 p.m. Areas of volunteer opportunities with the Wellness Clinic include greeting clients, providing the necessary forms to the clients, assist the Veterinarian during exams, and data entry for invoicing.

 Pet First Aid Kits: We need volunteers to assist in getting donated items for Pet First Aid kits as well as assembling these kits.

 Handymen (or Women!) : Owning a facility requires lots of TLC! If you are handy and have skills in carpentry, electrical, heating / air conditioning, etc., we’d love to be able to utilize your skills!  Public Relations: If you have graphic design skills and can help us make posters, brochures, programs, we need your help! Many of our special events require advertising and we need creative people to help us get the word out. If you love to write, we also need assistance with writing and distributing media releases!

IV. Availability

 A few hours a week. How many:______What days available:______ A few hours month. Hrs per month:______What days available: ______ Time available. Days:______Time of day:______

How did you hear about us? ______Can you provide references? YES NO If so, please list here: Name: ______Relationship:______Phone Number or email address: ______

Name: ______Relationship:______Phone Number or email address: ______

V. Release

By signing below, I confirm that all information that appears on the Hanover County Volunteer Personal Data Form is accurate and correct and that I have disclosed any and all information relating to past criminal offenses, traffic infractions, animal cruelty, and/or administrative findings of child abuse/neglect. By signing below, I also confirm that I am not currently charged with any criminal or traffic offenses and/or that I am not the subject of an administrative investigation related to child abuse/neglect.

I, the undersigned volunteer or parent or guardian (if volunteer under 18) understand and agree that the possibility of injury may occur while working with animals. I, the undersigned volunteer (or parent or guardian), desiring to donate my time and talents to the Hanover Humane Society do hereby agree to indemnify, release and hold harmless the Hanover Humane Society from any loss or injury that may result from my volunteer activities. Any tangible property that may be produced during the course of my volunteering with Hanover Humane Society is the property of Hanover Humane Society.

______Signature of Volunteer Date

______Signature of Parent/Guardian (if volunteer under 18) Date