Tufts Wildlife Clinic Volunteer Application

Volunteers are an important part of what keeps us functioning. They are in the middle of everything and get exposed to a lot of our native species through the work of our staff and students. The volunteer role is to support the staff and students in caring for our injured wildlife. Usually a volunteer would be cleaning a cage while the doctor is doing a treatment. Volunteers are also responsible for breaking down cages that animals have moved out of, setting up cages for new cases, doing laundry, sweeping, mopping, washing dishes, and assistance in the baby room once trained. Volunteers are not allowed to handle the animals. You must be 18 years of age or older to apply for this position.

Contact Information Name Street Address City ST ZIP Code Personal Phone Work Phone E-Mail Address Medical Insurance Company Insurance Policy Number

Availability We require a 6-month commitment one day a week in the following shifts. Please check all shifts for which you could volunteer. Some shifts may not currently be available (there could be as much as a 6-month waiting list for some shifts) so it is to your advantage to select as many possible shifts and we will try to fit you in the one that works best for you.

8am-noon ___Mon ___Tue ___Wed ___Thur ___Fri ___Sat ___Sun

1pm-5pm ___Mon ___Tue ___Wed ___Thur ___Fri n/a n/a

Education What is the highest level of education you have completed?

___High School/GED ___4-Year College Degree (BA, BS) ___Some College ___Master’s Degree ___2-Year College Degree (Associates) ___Doctoral Degree ___Professional Degree (DVM, MD, JD) ___Other: ______

Work Experience Please let us know your most recent work experiences

Place of Employment Duties Hours per week

Tufts Wildlife Clinic Page 1 of 2 200 Westboro Rd, North Grafton, MA 01536 http://vet.tufts.edu/wildlife Volunteer Experience If you have other volunteer experience, we would love to hear about it.

Organization Responsibilities Dates

Special Skills or Qualifications Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.

How Did You Hear About Us? How did you hear about our volunteer program?

Personal References Please let us know two personal references.

1) Phone:

2) Phone:

Person to Notify in Case of Emergency Name Relationship Phone (Day) Phone (Evening)

Signature By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

Signature Date: Please mail this form to the address in the footer or email it to: [email protected]

Tufts Wildlife Clinic Page 2 of 2 200 Westboro Rd, North Grafton, MA 01536 http://vet.tufts.edu/wildlife