Volunteer Application and Agreement Form Thank you for your interest in volunteering with The Animal Care Society. The Society is a non-profit, 501(c)3 corporation which operates a no-kill shelter and foster care program for dogs, puppies, cats and kittens in need of loving homes. Volunteers with a variety of skills are needed to ensure the success of these programs. Your help is GREATLY appreciated. Please take the time to fill out this application and read and sign the agreement. This information will help us identify the volunteer duties that you would enjoy most and keep you posted on new projects. After we review your information, a shelter representative will contact you to discuss volunteer opportunities with The Animal Care Society that are compatible with your skills and experience. Age Group?*16-1920-3031-5051+Name*FirstLastAddress*Street AddressAddress Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificStateZip CodePreferred Phone*FaxEmail*Best way to contact you?*Please check the volunteer services you are interested in providing:*TransportDog walking / Feeding /CareFosteringAssisting at EventsClerical / ComputerCat CareFundraising - Boutique, Yard Sale, Bark in the Park, RoadblocksVeterinary AssistanceTelephone CallsCoordinating Events / Volunter OpportunitiesShelter MaintenanceWriting for NewsletterOtherOther (please explain)Check the corresponding box if you have experience or training in any of the following areas.*Dog TrainingGroomingFundraisingVeterinary AssistanceAnimal RescueKennel AssistantWhelpingWritingComputers OtherNone of these areasOther (please explain)Please provide specifics for any areas you checked:*Do you have a specific time available to volunteer or are you flexible?*Have you ever volunteered at another shelter or animal related facility and/or do you hold any animal organization memberships? If so, please explain:*Would you be willing to place and maintain one or more canisters at local businesses to help with fundraising?*YesNoIf so, how many?Any other information that you think we should have to get to know you better:*Do you presently own a dog or cat?*YesNoIf yes, please describe:If you do not currently own a dog or cat, have you owned dogs or cats in the past?YesNoVOLUNTEER WAIVER (Please read) This waiver agreement, made and entered into and between the Animal Care Society, 12207 Westport Road, Louisville, KY and the volunteer named below: WITNESS: The parties to this Waiver Agreement do hereby mutually recognize THE ANIMAL CARE SOCIETY does not provide Worker’s Compensation or any other types of liability insurance to Volunteers. Accordingly, persons such as Volunteers are not covered by THE ANIMAL CARE SOCIETY for any forms of insurance, or to be paid salary, commission, or expenses whatsoever. Through this Waiver Agreement, the Volunteer does hereby knowingly release and hold faultless and harmless THE ANIMAL CARE SOCIETY, its Board of Directors and any employee for any injury, accident or damage sustained by the Volunteer while serving in such capacity. WITNESS the signature of the parties this _____ day of _____________, 20 ____. __________________________ __________________________ Witness-Animal Care Society Volunteer __________________________ If under 18, parent or guardian must sign
